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Abstract (text)
Relationships between dyspeptic symptoms and gastrointestinal motility in patients with type 1 (insulin-dependent) diabetes mellitus.
Reports on motor abnormalities in Type 1 (insulin-dependent) diabetes mellitus are inconsistent. In 20 Type 1 diabetic patients and in 11 control subjects antroduodenojejunal manometry was performed under euglycaemic conditions in order to examine the prevalence of gastric and small intestinal motor abnormalities in relation to dyspeptic symptoms and the degree of cardiac autonomic neuropathy. In diabetic patients compared to control subjects phase III (regular, high-amplitude contractile activity at maximal frequency) involved the gastric antrum less often (12 vs 35%, p & 0.05), the duration of phase I (motor quiescence) was shorter (6 +/- 1 vs 21 +/- 4 min, p & 0.002) and in phase II (irregular motor activity) the frequency of duodenal and jejunal contractions was higher. After a meal the duration of the fed state was shorter in diabetic patients with symptoms during the study than in diabetic patients without symptoms and than in control subjects (57 +/- 27 vs 157 +/- 11 and 140 +/- 13 min, p & 0.02). Postprandial antral hypomotility was seen in diabetic patients with symptoms only in the first 30 min after the meal. One hour after the meal the frequency of duodenal and jejunal contractions was again higher in diabetic patients. In diabetic patients compared to control subjects more burst activity (clusters of non-propagated high-amplitude contractile activity at maximal frequency) was seen (7.9 +/- 1.6 vs 0.8 +/- 0.5% of the total time of study, p & 0.002). No correlation was found between manometric parameters and the degree of cardiac autonomic neuropathy.(ABSTRACT TRUNCATED AT 250 WORDS)
PMID: 8243875 [Pubmed - MEDLINE]
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丁香园旗下网站LEEP锥切术在低度宫颈上皮内瘤变诊治中价值的探讨--《中国临床医生》2014年06期
LEEP锥切术在低度宫颈上皮内瘤变诊治中价值的探讨
【摘要】：目的探讨LEEP锥切术在低度宫颈上皮内瘤变宫颈上皮轻度非典型增生(CINⅠ)临床诊断和治疗中的价值。方法对2007年1月至2012年12月期间286例经阴道镜宫颈活检病理证实的CINⅠ患者行LEEP锥切术的完整病例及随访资料进行回顾性分析。结果①286例CINⅠ患者行LEEP锥切术后病理升级者53例(18.53%),其中CINⅡ者42例(14.68%),CINⅢ者11例(3.85%)。按照LEEP术后病理结果显示的不同CIN级别分组,各组LEEP术前宫颈薄层液基细胞学报告为高度鳞状上皮内病变(HSIL)的例数分别为:炎症0/53例(0),CINI 15/180例(8%),CINII 5/42例(12%),CINⅢ4/11例(36%),P=0.026;同时合并HR-HPV感染的各组例数分别为:炎症30例(57%),CINI 127例(71%),CINII 34例(81%),CINⅢ9例(82%),P=0.049;LEEP术前阴道镜提示多点病灶的各组例数分别为:炎症0例(0),CINI 10例(6%),CINII 5例(12%),CINⅢ8例(80%),P=0.000。②对LEEP术后病理未升级的233例患者进行12~72个月的随访,病变持续存在19例(8.2%),病变进展6例(2.6%),其中CINII 5例,CINⅢ1例。此25例患者中术后持续高危人乳头瘤病毒(HR-HPV)感染15例;50岁患者中持续和进展病例共10例。③157例LEEP术前HPV阳性患者中107例(68.8%)术后HPV阴转。结论对细胞学报告为HSIL、合并HRHPV感染、阴道镜活检病理证实多点CINⅠ患者,建议行LEEP锥切术进一步明确诊断。LEEP锥切术后HR-HPV持续感染及年龄超过50岁是病变持续及进展的高危因素,需要严密随访。LEEP锥切术是CINⅠ患者的一种可选择的有效诊治措施。
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Examination of self-directed learning readiness of paramedic undergraduates: A multi-institutional study
Brett Williams, Malcolm Boyle, Christian Winship, Richard Brightwell, Scott Devenish, Graham Munro
Background: The ability to engage in self-directed learning (SDL) is considered to be essential for professional practice in out-of-hospital settings since paramedics are expected to continue and update their knowledge and understanding throughout their professional career. Objectives: The objective of this study was to determine undergraduate paramedic students’ attitudes and readiness towards self-directed learning at four Australian universities. Methods: A cross-sectional study involving a paper-based questionnaire was undertaken employing a convenience sample of undergraduate paramedic students in semester 1, 2010. Attitudes and readiness for self-directed learning were elicited by the Self-directed Learning Readiness Scale (SDLRS) consisting of a 5-point Likert scale (1=Strongly Disagree and 5=Strongly Agree). Findings: There were 259 students who participated.
Most students were from Monash University (n=113) and Charles Sturt University (n=77). Two-thirds (n=169) of students were & 25 years of age with 54% female. Students from Queensland University of Technology produced the highest SDL score 160.38 (SD=13.56) while participants from Charles Sturt University produced the lowest mean score 154.60 (SD=14.51). Second year students produced the highest total mean score 157.52 (SD=15.19). Statistical significance was identified between the Self-Control Subscale F=3.10, p=0.010 and Self-Management Subscale F=2.83, p=0.017. Conclusions: This is the first study of its kind involving paramedic undergraduate students in Australia. The results from this study suggest undergraduate paramedic students from four different Australian universities possess an adequate level of self-directed learning readiness. As paramedic-orientated degree programs continue to emerge and develop, establishing SDL needs will assist paramedic educators in diagnosing student learning needs, and assist in shaping contemporary and student-centred curriculum.
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