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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Growth Hormone and Gender. Studies in Healthy Adults and in Patients with Growth Hormone Disorders

Edén Engström, Britt January 2001 (has links)
The use of a new, more sensitive immunoassay for growth hormone (GH) revealed that the serum levels in men were lower than expected in sera drawn ambulatory in the morning after an overnight fast and that the gender difference was more than 10 times greater than reported. These observations led to a more thorough study on the impact of gender and sex steroids on the levels of GH and other hormones in ambulatory morning samples and over a 24-hour period. Furthermore, the impact of gender was studied in GH deficient (GHD) patients and healthy young adults treated with GH, and in patients with acromegaly treated with octreotide. An 80-fold gender difference in the morning GH levels was observed in young individuals as a reaction to ambulation, with decreased levels in men and increased in women. Oral contraceptives (OCs) given to women further increased the morning GH levels. During the day, higher outputs of epinephrine and lower levels of GH were seen in the men, while no gender differences were seen at night. The gender difference in morning GH levels decreased with age due to opposite changes in men and women. Administration of 17β-estradiol (E2) via subcutaneous implants in postmenopausal women, which increased the E2-concentrations to luteal phase levels, had no effect on the morning GH levels, indicating that the different reactions to ambulation do not appear to result from a direct sex steroid effect alone. Short-term administration of GH to young, healthy adults resulted in larger effects on insulin-like growth factor I (IGF-I) and other key metabolic parameters in men than in women. The smallest response was noted in women taking OCs. The clinical studies involving long-term GH treatment of patients with GHD demonstrate a gender difference in GH responsiveness, with women being less sensitive than men, a fact which should have a therapeutic impact in patients with GH disorders. A further gender difference of therapeutic importance was observed in men and women with acromegaly. Long-term treatment with a slow-release formulation of octreotide resulted in higher IGF-I levels in the men, despite equal doses of the drug and similar levels of GH.
22

Hodnocení kompenzace chůzových testů a testů rovnováhy u pacientů po operaci vestibulárního schwannomu / The evaluation of gait and balance tests in patients after vestibular schwannoma surgery

Chejnovská, Lucie January 2018 (has links)
The thesis deals with the evaluation of gait and balance tests in patients after vestibular schwannoma surgery. The experimental part focuses on the evaluation of dynamics of walking tests during hospitalization of patients diagnosed with vestibular schwannoma. The aim of the experimental part is also to analyze statistically significant correlations between measurable parameters of vestibulo-ocular reflex and walking tests and to evaluate the correlation between the subjective scale of fall fear and the objective assessment of walking and dynamic postural stability. A total of 28 patients aged 33 to 68 (14 men and 14 women) were incuded in the research with diagnosed vestibular schwannoma. Measurements were performed three times in patients (before surgery, after surgery and before the end of hospitalization). After the surgery, in addition to standard rehabilitation, training with visual biofeedback was included using the interactive Homebalance system. Gait and balance assessments were performed throug the tests Timed Up and Go, Four Step Square Test and Functional Gait Assessment. Examinations were complemented by a questionnaire of subjective assessment of fear of falling Falls Efficacy Scale. Statistical analysis showed a significant correlation coefficient in the correlation of Four Step...
23

Repouso de três horas no leito após cateterismo cardíaco diagnóstico com introdutor 6 french não aumenta complicações decorrentes da punção arterial : ensaio clínico randomizado

Matte, Roselene January 2013 (has links)
A despeito das evidências de que a redução do repouso no leito após cateterismo cardíaco diagnóstico sob abordagem transfemoral não aumenta as complicações decorrentes da punção arterial, esta prática ainda não está incoporada em muitos laboratórios de hemodinâmica (LH), principalmente em centros latino-americanos. Buscando preencher esta lacuna do conhecimento testou-se neste estudo se a redução do tempo de repouso no leito para três horas (GI), comparada a repouso de cinco horas (GC), não aumenta as complicações decorrentes da punção arterial após cateterismo cardíaco diagnóstico eletivo com introdutor 6 French e abordagem transfemoral. Foi conduzido um Ensaio clínico randomizado (ECR) no LH de um hospital público e universitário, região metropolitana, do Rio Grande do Sul no período de janeiro de 2011 a setembro de 2013. Foram incluídos pacientes adultos ambulatoriais. O GI deambulou três horas após a retirada do introdutor, e o GC após cinco horas. Todos pacientes permaneceram cinco horas na sala de observação onde foram observados a cada hora, pela equipe de enfermagem, e contatados por telefone em 24, 48 e 72 horas após a alta hospitalar. Foram avaliados os seguintes desfechos: hematoma, sangramento, hematoma retroperitoneal, pseudoaneurisma, formação de fístula arteriovenosa e reação vaso vagal Incluíram-se 730 pacientes: GI (n=367) e GC (n=363), média de idade de 62+11 anos. Durante a permanência dos pacientes na sala de observação do LH o hematoma foi a complicação mais observada em ambos os grupos, 12(3%) no GI e 13(4%) no GC (P=0,87); no GI 11(3%) pacientes apresentaram hematoma classificado como pequeno e 1(0,3%) apresentou hematoma classificado como grande; enquanto que no GC 11(3%) pacientes apresentaram hematoma classificado como pequeno e 2(0,6%) apresentaram hematoma classificado como grande; o sangramento ocorreu em 4(1%) dos pacientes no GI e 6(2%) no GC (P=0,51), tanto no GI como no GC a ocorrência de sangramento foi considerada menor. A reação vaso vagal ocorreu em 5(1,4%) pacientes no GI e 4(1,1%) pacientes no GC (P=0,75). Nos contatos em 24, 48 e 72 horas a equimose foi a complicação mais prevalente nos três períodos, para ambos os grupos, seguida pelo relato de dor no local da punção, para nenhuma das comparações foi observado significância estatistica. Apenas 1(0,3%) paciente do GC apresentou pseudoaneurisma no contato em 48 horas, necessitando retornar ao hospital para tratamento. Não foi observada nenhuma outra complicação durante todo o período do estudo. Os resultados deste estudo permitem concluir que a intervenção na redução do tempo de repouso para três horas após cateterismo cardíaco diagnóstico eletivo mostrou-se segura, sem aumento de complicações quando comparada aos pacientes que permaneceram em repouso de cinco horas. / Despite evidence that point out that reduction of rest in bed time after diagnostic cardiac catheterization using transfemoral approach does not contribute to complications of arterial puncture, such practice was still not incorporated into several hemodynamic laboratories (HL), especially in Latin American centers. In order to fill this knowledge gap, this study presents a test for the reduction of rest in bed time of three hours (IG) compared to rest in bed time of five hours (CG), aiming at verifying if the time does not increase complications of arterial puncture after diagnostic cardiac catheterization using 6 French introducer and the transfemoral approach. A randomized clinical trial (RCT) was conducted at a HL in a public university hospital located in the metropolitan area of Rio Grande do Sul/Brazil, between January 2011 and September 2013. Adult outpatients were included in this trial. The IG remained three hours after the withdrawal of the 6 French introducer and the CG remained five hours in the ambulatory. All patients remained five hours in the observation room, being checked every one hour by the nursing staff and being contacted by telephone at 24, 48 and 72 hours after the discharge. The outcomes hematoma, bleeding, retroperitoneal hemorrhage, pseudoaneurysm, arteriovenous fistula and vasovagal response were assessed. For the study, 730 patients were included and separated into GI (n=367) and GC (n=363), mean age of 62 ± 11. While patients remained in the observation room in the HL, the hematoma was the most common complication observed in both groups, 12(3%) in IG and 13(4%) in CG (P=0.87); in IG, 11(3%) patients presented small hematoma and 1(0.3%) presented large hematoma; in CG, 11(3%) patients presented small hematoma and 2(0.6%) presented large hematoma; bleeding occurred in 4(1%) patients in IG and 6(2%) in CG (P=0.51); both IG and CG presented minor bleeding occurrences. The vasovagal response occurred in 5(1.4%) patients in IG and 4(1.1%) patients in CG (P=0.75). During telephone contacts at 24, 48 and 72 hours, ecchymosis was the most prevalent complication for the three periods in both groups, followed by pain at the puncture site. Statistical significance was not observed in any of the comparisons. Only 1(0.3%) patient in the CG had pseudoaneurysm within 48 hours after discharge and had to return to the hospital for treatment. No other complications were observed during the study period. The results of this study demonstrate that reducing the time of rest in bed for three hours after diagnostic cardiac catheterization proved to be a safe procedure, with no increase in complications when compared to patients who remained resting in bed for five hours. / Con relación a las evidencias de que la reducción del reposo en el lecho tras cateterismo cardíaco diagnóstico bajo abordaje transfemoral no aumenta las complicaciones decurrentes de la punción arterial, esta práctica aún no está incorporada en muchos laboratorios de hemodinámica (LH), principalmente en centros latinoamericanos. En la tentativa de rellenar este hueco del conocimiento se hizo un test en este estudio para saber si la reducción del tiempo de reposo en el leco para tres horas (GI), comparada a cinco horas (GC), no aumenta las complicaciones decurrentes de la punción arterial tras cateterismo cardíaco diagnóstico con introductor 6 French y vía transfemoral. Fue dirigido un Ensayo clínico randomizado (ECR) en LH de un hospital público y universitario, región metropolitana, de Río Grande del Sur en el periodo de enero de 2011 a septiembre de 2013. Fueron incluidos pacientes adultos ambulatoriales. GI deambuló tres horas luego de la retirada del introductor, y GC tras cinco horas. Todos los pacientes permanecieron cinco horas en la sala de observación donde fueron observados a cada hora, por el equipo de enfermería, y contactados por teléfono en 24, 48 y 72 horas tras el alta hospitalario. Fueron evaluados los siguientes resultados: hematoma, hemorragia, hematoma retroperitoneal, pseudoaneurisma, formación de fístula arteriovenosa, reacción vaso y vagal. Se incluyeron 730 pacientes en la sala de observación de LH, el hematoma fue la complicación más observada en ambos grupos, 12 (3%) GI y 13 (4%) GC (P=0,87); en GI 11(3%) pacientes presentaron hematoma clasificado como pequeño y 1(0,3%) presentó hematoma clasificado como grande; mientras que en GC 11(3%) pacientes presentaron hematoma clasificado como pequeño y 2 (0,6%) presentaron hematoma clasificado como grande; la hemorragia ocurrió en 4 (1%) de los pacientes en GI y 6 (2%) en GC (P=0,51), tanto en GI como en GC la ocurrencia de hemorragia fue considerada menor. La reacción vaso vagal ocurrió en 5 (1,4%) pacientes en GI y 4 (1,1%) pacientes en GC (P=0,75). En los contactos en 24, 48 y 72 horas la equimosis fue la complicación que más prevaleció en los tres periodos, para ambos grupos, seguida por el relato de dolor en el local de la punción, para ninguna de las comparaciones fue observada significancia estadística. 1 (0,3%) paciente de GC presentó pseudoaneurisma en el contacto en 48 horas, necesitando volver al hospital para tratamiento. No se observó ninguna otra complicación durante todo el periodo del estudio. Los resultados de este estudio permiten concluir que la intervención en la reducción del tiempo de reposo para tres horas luego de cateterismo cardíaco diagnóstico electivo es posible y segura, sin aumento de complicaciones cuando comparada a los pacientes que permanecieron en reposo de cinco horas.
24

Repouso de três horas no leito após cateterismo cardíaco diagnóstico com introdutor 6 french não aumenta complicações decorrentes da punção arterial : ensaio clínico randomizado

Matte, Roselene January 2013 (has links)
A despeito das evidências de que a redução do repouso no leito após cateterismo cardíaco diagnóstico sob abordagem transfemoral não aumenta as complicações decorrentes da punção arterial, esta prática ainda não está incoporada em muitos laboratórios de hemodinâmica (LH), principalmente em centros latino-americanos. Buscando preencher esta lacuna do conhecimento testou-se neste estudo se a redução do tempo de repouso no leito para três horas (GI), comparada a repouso de cinco horas (GC), não aumenta as complicações decorrentes da punção arterial após cateterismo cardíaco diagnóstico eletivo com introdutor 6 French e abordagem transfemoral. Foi conduzido um Ensaio clínico randomizado (ECR) no LH de um hospital público e universitário, região metropolitana, do Rio Grande do Sul no período de janeiro de 2011 a setembro de 2013. Foram incluídos pacientes adultos ambulatoriais. O GI deambulou três horas após a retirada do introdutor, e o GC após cinco horas. Todos pacientes permaneceram cinco horas na sala de observação onde foram observados a cada hora, pela equipe de enfermagem, e contatados por telefone em 24, 48 e 72 horas após a alta hospitalar. Foram avaliados os seguintes desfechos: hematoma, sangramento, hematoma retroperitoneal, pseudoaneurisma, formação de fístula arteriovenosa e reação vaso vagal Incluíram-se 730 pacientes: GI (n=367) e GC (n=363), média de idade de 62+11 anos. Durante a permanência dos pacientes na sala de observação do LH o hematoma foi a complicação mais observada em ambos os grupos, 12(3%) no GI e 13(4%) no GC (P=0,87); no GI 11(3%) pacientes apresentaram hematoma classificado como pequeno e 1(0,3%) apresentou hematoma classificado como grande; enquanto que no GC 11(3%) pacientes apresentaram hematoma classificado como pequeno e 2(0,6%) apresentaram hematoma classificado como grande; o sangramento ocorreu em 4(1%) dos pacientes no GI e 6(2%) no GC (P=0,51), tanto no GI como no GC a ocorrência de sangramento foi considerada menor. A reação vaso vagal ocorreu em 5(1,4%) pacientes no GI e 4(1,1%) pacientes no GC (P=0,75). Nos contatos em 24, 48 e 72 horas a equimose foi a complicação mais prevalente nos três períodos, para ambos os grupos, seguida pelo relato de dor no local da punção, para nenhuma das comparações foi observado significância estatistica. Apenas 1(0,3%) paciente do GC apresentou pseudoaneurisma no contato em 48 horas, necessitando retornar ao hospital para tratamento. Não foi observada nenhuma outra complicação durante todo o período do estudo. Os resultados deste estudo permitem concluir que a intervenção na redução do tempo de repouso para três horas após cateterismo cardíaco diagnóstico eletivo mostrou-se segura, sem aumento de complicações quando comparada aos pacientes que permaneceram em repouso de cinco horas. / Despite evidence that point out that reduction of rest in bed time after diagnostic cardiac catheterization using transfemoral approach does not contribute to complications of arterial puncture, such practice was still not incorporated into several hemodynamic laboratories (HL), especially in Latin American centers. In order to fill this knowledge gap, this study presents a test for the reduction of rest in bed time of three hours (IG) compared to rest in bed time of five hours (CG), aiming at verifying if the time does not increase complications of arterial puncture after diagnostic cardiac catheterization using 6 French introducer and the transfemoral approach. A randomized clinical trial (RCT) was conducted at a HL in a public university hospital located in the metropolitan area of Rio Grande do Sul/Brazil, between January 2011 and September 2013. Adult outpatients were included in this trial. The IG remained three hours after the withdrawal of the 6 French introducer and the CG remained five hours in the ambulatory. All patients remained five hours in the observation room, being checked every one hour by the nursing staff and being contacted by telephone at 24, 48 and 72 hours after the discharge. The outcomes hematoma, bleeding, retroperitoneal hemorrhage, pseudoaneurysm, arteriovenous fistula and vasovagal response were assessed. For the study, 730 patients were included and separated into GI (n=367) and GC (n=363), mean age of 62 ± 11. While patients remained in the observation room in the HL, the hematoma was the most common complication observed in both groups, 12(3%) in IG and 13(4%) in CG (P=0.87); in IG, 11(3%) patients presented small hematoma and 1(0.3%) presented large hematoma; in CG, 11(3%) patients presented small hematoma and 2(0.6%) presented large hematoma; bleeding occurred in 4(1%) patients in IG and 6(2%) in CG (P=0.51); both IG and CG presented minor bleeding occurrences. The vasovagal response occurred in 5(1.4%) patients in IG and 4(1.1%) patients in CG (P=0.75). During telephone contacts at 24, 48 and 72 hours, ecchymosis was the most prevalent complication for the three periods in both groups, followed by pain at the puncture site. Statistical significance was not observed in any of the comparisons. Only 1(0.3%) patient in the CG had pseudoaneurysm within 48 hours after discharge and had to return to the hospital for treatment. No other complications were observed during the study period. The results of this study demonstrate that reducing the time of rest in bed for three hours after diagnostic cardiac catheterization proved to be a safe procedure, with no increase in complications when compared to patients who remained resting in bed for five hours. / Con relación a las evidencias de que la reducción del reposo en el lecho tras cateterismo cardíaco diagnóstico bajo abordaje transfemoral no aumenta las complicaciones decurrentes de la punción arterial, esta práctica aún no está incorporada en muchos laboratorios de hemodinámica (LH), principalmente en centros latinoamericanos. En la tentativa de rellenar este hueco del conocimiento se hizo un test en este estudio para saber si la reducción del tiempo de reposo en el leco para tres horas (GI), comparada a cinco horas (GC), no aumenta las complicaciones decurrentes de la punción arterial tras cateterismo cardíaco diagnóstico con introductor 6 French y vía transfemoral. Fue dirigido un Ensayo clínico randomizado (ECR) en LH de un hospital público y universitario, región metropolitana, de Río Grande del Sur en el periodo de enero de 2011 a septiembre de 2013. Fueron incluidos pacientes adultos ambulatoriales. GI deambuló tres horas luego de la retirada del introductor, y GC tras cinco horas. Todos los pacientes permanecieron cinco horas en la sala de observación donde fueron observados a cada hora, por el equipo de enfermería, y contactados por teléfono en 24, 48 y 72 horas tras el alta hospitalario. Fueron evaluados los siguientes resultados: hematoma, hemorragia, hematoma retroperitoneal, pseudoaneurisma, formación de fístula arteriovenosa, reacción vaso y vagal. Se incluyeron 730 pacientes en la sala de observación de LH, el hematoma fue la complicación más observada en ambos grupos, 12 (3%) GI y 13 (4%) GC (P=0,87); en GI 11(3%) pacientes presentaron hematoma clasificado como pequeño y 1(0,3%) presentó hematoma clasificado como grande; mientras que en GC 11(3%) pacientes presentaron hematoma clasificado como pequeño y 2 (0,6%) presentaron hematoma clasificado como grande; la hemorragia ocurrió en 4 (1%) de los pacientes en GI y 6 (2%) en GC (P=0,51), tanto en GI como en GC la ocurrencia de hemorragia fue considerada menor. La reacción vaso vagal ocurrió en 5 (1,4%) pacientes en GI y 4 (1,1%) pacientes en GC (P=0,75). En los contactos en 24, 48 y 72 horas la equimosis fue la complicación que más prevaleció en los tres periodos, para ambos grupos, seguida por el relato de dolor en el local de la punción, para ninguna de las comparaciones fue observada significancia estadística. 1 (0,3%) paciente de GC presentó pseudoaneurisma en el contacto en 48 horas, necesitando volver al hospital para tratamiento. No se observó ninguna otra complicación durante todo el periodo del estudio. Los resultados de este estudio permiten concluir que la intervención en la reducción del tiempo de reposo para tres horas luego de cateterismo cardíaco diagnóstico electivo es posible y segura, sin aumento de complicaciones cuando comparada a los pacientes que permanecieron en reposo de cinco horas.
25

Multisensory Integration of Lower-Limb Somatosensory Neuroprostheses: from Psychophysics to Functionality

Christie, Breanne P. 28 January 2020 (has links)
No description available.
26

Postoperativ vård efter ortopedisk kirurgi : en litteraturöversikt / Postoperative care after orthopedic surgery : a literature review

Hjelmfeldt, Oskar, Lundén, Sara January 2024 (has links)
Bakgrund   Muskuloskeletala systemet, även benämnt som rörelseapparaten, kräver alltid postoperativ omvårdnad efter operation i de nedre extremiteterna. En viktig aspekt av vårdprocessen är personcentrerad omvårdnad, som betonar vikten av preoperativ information, postoperativ rehabilitering och aktiv patientmedverkan. Tidig mobilisering efter operation är avgörande för att minska risken för komplikationer och förkorta sjukhusvistelsen, samtidigt som det finns en strävan att förbättra patientens livskvalitet och återställa funktion. Denna studie fokuserar på att analysera den postoperativa vården efter ortopedisk kirurgi. Syfte  Syftet var att belysa postoperativ vård efter ortopedisk kirurgi. Metod  En icke-systematisk litteraturöversikt baserad på 15 vetenskapliga originalartiklar med kvalitativa, kvantitativa eller mixad design. Artiklarna valdes ut från databaserna PubMed och CINAHL. Samtliga artiklar har kvalitetsgranskats utifrån Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering och kvalitet. Integrerad dataanalys användes för att sammanställa resultatet. Resultat Resultatet sammanställdes med hjälp av två huvudkategorier: Tidig mobilisering och Vårdandets perspektiv. Resultatet visade att tidig mobilisering är fördelaktigt i det tidiga stadiet av postoperativ omvårdnad då det påskyndar rehabiliteringen, förbättrar behandlingsprocessen och sänker vårdkostnaderna. Dessutom framhölls vikten av väl anpassad patientinformation för att stärka den personcentrerade vården. Det är avgörande att vårdgivarna anpassar informationen för att optimera varje patients behandlingsupplevelse och resultat. Slutsats Denna litteraturöversikt understryker vikten av tidig mobilisering efter ortopedisk kirurgi för att påskynda patientens återhämtning, förkorta sjukhusvistelser samt minska smärta, vilket förbättrar både fysiska och psykiska utfall. Genom att implementera ett personcentrerat förhållningssätt som anpassade smärtbehandlingsprotokoll och grundlig preoperativ utbildning kan vårdgivare övervinna hinder som åldersfaktorer och rörelserädsla. Tidig mobilisering, som en del av ERAS-program, visar även ekonomiska fördelar genom minskade vårdkostnader och effektivare resursanvändning, vilket gör det till en kritisk komponent i postoperativ vård. / Background The musculoskeletal system always requires postoperative care after surgery in the lower extremities. An important aspect of the care process is person-centered nursing, which emphasizes the importance of preoperative information, postoperative rehabilitation, and active patient participation. Early mobilization after surgery is essential to reduce risk of complications and shorten the hospital stay, while striving to improve the patient's quality of life and restore function. This study focuses on analyzing the postoperative care after orthopedic surgery. Aim The aim was to shed light on postoperative care after orthopedic surgery. Method A non-systematic literature review based on 15 original scientific articles with a qualitative, quantitative or mixed design. The articles were selected from the databases PubMed and CINAHL. The articles have been quality checked based on Sophiahemmet University's assessment document for scientific classification and quality. Integrated data analysis was used to compile the results. Results The results were compiled with the help of two main categories: Early Mobilization and the Nursing perspective. The result showed that early mobilization is beneficial in the early stage of postoperative care that accelerates rehabilitation, improves the treatment process and lowers costs. Additionally, the importance of well-adapted patient information to strengthen person-centered care was highlighted. It's critical that caregivers adapt the information to optimize each patient's treatment experience and outcomes. Conclusions This literature review highlights the importance of early mobilization after orthopedic surgery to accelerate recovery, shorten hospital stays, and reduce pain, improving both physical and psychological outcomes. Implementing person-centered approaches such as customized pain management protocols and thorough preoperative education, caregivers can overcome barriers like age factors and movement fear. Early mobilization, as part of ERAS, also demonstrates economic benefits through reduced healthcare costs and more efficient resource usage, making it a critical component of postoperative care.
27

Étude du contrôle postural quasi-statique et dynamique en position debout des personnes ayant une lésion médullaire incomplète

Lemay, Jean-François 10 1900 (has links)
No description available.
28

Mise en scène de la déambulation et écriture de la ville dans un corpus d'oeuvres du XVIIIe siècle / Staging of ambulation and writing on the city in a corpus of XVIIIth century works

Al-Mahyawi, Hussein 19 June 2012 (has links)
Dans le premier versant du XVIIIe siècle, la présence de Paris dans les œuvres littéraires demeure sous-jacente ou est seulement suggérée par un simple regard qui reste généralement distant. C’est notamment le cas dans Le Diable boiteux de Lesage où la déambulation dans la ville reste subordonnée aux priorités visuelles (depuis un lieu surplombant, le diable montre à son élève les différents aspects de la ville). C’est avec Rousseau qu’une problématique nouvelle de la déambulation apparaît. Dans ses écrits autobiographiques (Les Confessions, Les Rêveries du promeneur solitaire), le narrateur met en scène cette déambulation dans son parcours même : les marches ou les promenades propices à la rêverie, à la méditation et à la remémoration. Avec Rétif de Bretonne (Les Nuits de Paris) et Louis-Sébastien Mercier (Tableau de Paris), Paris apparaît comme l’espace par excellence d’une errance féconde. La capitale française cesse d’être à l’arrière-plan et devient un objet d’écriture à part entière. / In the first half of the eighteenth century, the presence of Paris in the literary works remains underlying or is merely suggested by a single and generally distant glance. This is notably the case in Lesage’s novel The Lame Devil where the wandering in the city remains subordinate to visual priorities (from an overlooking place, the devil shows his learner different aspects of the city). It is with Rousseau that a new problem on ambulation emerges. In his autobiographical writings (Confessions, Reveries of a Solitary Walker), the narrator portrays this ambulation in his very career: walks or promenades inspiring daydreaming, conductive to meditation and recalling memories. With Rétif de la Bretonne (Parisian Nights) and Louis-Sébastien Mercier (Panorama of Paris), Paris seems to be the ideal place for a fertile wandering. The French capital ceases to be in the background and becomes a subject of writing in its own right.
29

Final Scholarly Project: A Systematic Record Review of a Local Quality Improvement Impacts on Anesthesia Provider Knowledge and Attitudes Following a Presentation of Current Evidence-Based Practices Involving Intrathecal Mepivacaine Use in Total Joint Arthroplasty Surgical Patients

McClellan, Kevin 02 May 2023 (has links)
No description available.
30

Novel Oral Anticoagulants: Bedrest and Bleeding in Patients Undergoing Atrial Fibrillation Catheter Ablation

McWhirter, Lynn 01 January 2014 (has links)
Atrial fibrillation (AF), the most common cardiac arrhythmia in persons over age 65, is associated with an increased stroke risk necessitating the need for long-term oral anticoagulation for risk reduction. With the introduction of direct thrombin and factor Xa inhibitors in the US since 2010, these novel oral anticoagulants (NOACs) are increasingly being prescribed, replacing the use of warfarin, a vitamin K antagonist. AF catheter ablation (CA), an elective procedure requiring femoral vascular access is a treatment for drug refractory and persistent AF. Bedrest, limb immobilization, and limited head of bed elevation are nursing measures utilized following femoral venous, and sometimes arterial, sheath removal and hemostasis. Limited research is available on the appropriate duration of bedrest to minimize bleeding complications associated with AF ablation in patients who use NOACs. The purpose of this quality improvement project was to compare and evaluate the effect of bedrest duration on post-procedure bleeding outcomes, urinary complaints, and back pain among patients taking NOACs while undergoing AFCA. Thirty patients undergoing elective AFCA on NOACs were orally consented to participate in the study and placed on shortened (8 hours) or prolonged (>8 hours) bedrest following vascular hemostasis. Outcome measurements included bleeding after ambulation, back pain, and urinary complaints. Fifteen patients (50%) were on shortened bedrest and 15 (50%) were on prolonged bedrest. No statistically significant difference in bleeding, urinary complaints, or back pain were found. Since there is no clear advantage to prolonged bedrest for patients on NOACS after an AFCA procedure, clinicians should consider this when deciding on bedrest duration for their patients.

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