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1.
Roxane Borgès Da Silva André-Pierre Contandriopoulos Raynald Pineault Pierre Tousignant 《Canadian family physician Médecin de famille canadien》2014,60(10):e485-e492
Objective
To define a physician classification system based on practice settings and to analyze the service provision associated with those classifications.Design
A cross-sectional, retrospective study.Setting
Province of Quebec.Participants
All GPs in Quebec in 2002 who had been practising for at least 2 years.Main outcome measures
Practice setting variables were based on physician income in the different settings. Service provision was assessed using indicators related to continuity, comprehensiveness, accessibility, and productivity of services provided by the GPs. A multiple correspondence analysis with ascending hierarchical classification was conducted to construct the taxonomy of GPs based on their practice settings.Results
Our study produced 7 practice setting models. Two were essentially single-practice models. The 5 others combined several settings. Service provision varied from one model to another. Continuity was greater in the private practice model, in which older GPs were predominant, while accessibility was greater in multi-institutional practice models, in which younger GPs were more active.Conclusion
To ensure balance between continuity, accessibility, and comprehensiveness in primary care services provided by GPs, it is important to consider the service provision associated with different practice models. 相似文献2.
Beau Blois 《Canadian family physician Médecin de famille canadien》2012,58(3):e172-e178
Objective
To assess the efficacy of an office-based, family physician–administered ultrasound examination to screen for abdominal aortic aneurysm (AAA).Design
A prospective observational study. Consecutive patients were approached by nonphysician staff.Setting
Rural family physician offices in Grand Forks and Revelstoke, BC.Participants
The Canadian Society for Vascular Surgery screening recommendations for AAA were used to help select patients who were at risk of AAA. All men 65 years of age or older were included. Women 65 years of age or older were included if they were current smokers or had diabetes, hypertension, a history of coronary artery disease, or a family history of AAA.Main outcome measures
A focused “quick screen,” which measured the maximal diameter of the abdominal aorta using point-of-care ultrasound technology, was performed in the office by a resident physician trained in emergency ultrasonography. Each patient was then booked for a criterion standard scan (ie, a conventional abdominal ultrasound scan performed by a technician and interpreted by a radiologist). The maximal abdominal aortic diameter measured by ultrasound in the office was compared with that measured by the criterion standard method. The time to screen each patient was recorded.Results
Forty-five patients were included in data analysis; 62% of participants were men. The mean age was 73 years. The mean pairwise difference between the office-based ultrasound scan and the criterion standard scan was not statistically significant. The mean absolute difference between the 2 scans was 0.20 cm (95% CI 0.15 to 0.25 cm). Correlation between the scans was 0.81. The office-based ultrasound scan had both a sensitivity and a specificity of 100%. The mean time to screen each patient was 212 seconds (95% CI 194 to 230 seconds).Conclusion
Abdominal aortic aneurysm screening can be safely performed in the office by family physicians who are trained to use point-of-care ultrasound technology. The screening test can be completed within the time constraints of a busy family practice office visit. The benefit of screening for AAA in rural patients might be great if local diagnostic ultrasound service and emergent transport to a vascular surgeon are not available. 相似文献3.
Raffaella Capasso Eugenio Rossi Massimo Zeccolini Antonio Rotondo 《Journal of Ultrasound》2015,18(3):297-300
Purpose
To describe the characteristics of lymphangioma reporting a pediatric case of small bowel mesentery location, showing ultrasound-elastosonographic and computed tomography findings.Methods
A 7-year-old girl suffering from vomiting and abdominal pain underwent chest–abdomen radiography and abdomen ultrasound examination at our institution. These exams were repeated for 5 days after medical therapy and a computed tomography investigation was also performed.Results
Abdominal ultrasound and computed tomography examinations revealed the presence of a heterogeneous mesenteric mass occupying the right hemiabdomen displacing small bowel loops. Moreover, the mass had an irregular vascularisation pattern on color-Doppler study and appeared mostly green colored, like soft tissues, on elastosonographic colorimetric map. The little patient underwent surgery with removal of both the mass and the close adherent ileal loop. Finally, anatomopathologic diagnosis of mesenteric lymphangioma was made.Conclusions
Although mesenteric lymphangioma is a rare disease that presents neither clinical nor imaging typical features requiring invasive procedure to be diagnosed, ultrasound-elastosonographic findings can suggest a benign condition and computed tomography scan is useful in order to plan surgery. 相似文献4.
P. Pesce L. Cecchetto S. Brocco M. Bolognesi K. Sodhi N. G. Abraham D. Sacerdoti 《Journal of Ultrasound》2015,18(3):229-235
Abstract
Cardiorenal syndrome type 1 (CRS-1) is the acute kidney disfunction caused by an acute worsening of cardiac function. CRS-1 is the consequence of renal vasoconstriction secondary to renin–angiotensin system (RAS) activation. No animal models of CRS-1 are described in literature.Purpose
To characterize a murine model of CRS-1 by using a high-resolution ultrasound echo-color Doppler system (VEVO2100).Materials
Post-ischemic heart failure was induced by coronary artery ligation (LAD) in seven CD1 mice. Fifteen and thirty days after surgery, mice underwent cardiac and renal echo-color Doppler. Serum creatinine and plasma renin activity were measured after killing. Animals were compared to seven CD1 control mice.Results
Heart failure with left ventricle dilatation (end diastolic area, p < 0.05 vs. controls) and significantly reduced ejection fraction (EF; p < 0.01 vs. controls) was evident 15 days after LAD. We measured a significant renal vasoconstriction in infarcted mice characterized by increased renal pulsatility index (PI; p < 0.05 vs. controls) associated to increased creatinine and renin levels (p < 0.05 vs. controls)Conclusions
The mice model of LAD is a good model of CRS-1 evaluable by Doppler sonography and characterized by renal vasoconstriction due to the activation of the renin–angiotensin system secondary to heart failure. 相似文献5.
G. Barella S. Faverzani M. Faustini D. Groppetti A. Pecile 《Journal of Ultrasound》2014,17(4):287-292
Purpose
The ductus venosus (DV) blood flow has been studied in fetal lambs and in humans. This study aims to describe the velocities, the Doppler indices and the morphological patterns of the venous blood flow in the DV of canine fetuses during physiological pregnancy.Methods
The DV of 55 canine fetuses has been evaluated and the waveforms described using B-mode, color and pulsed-wave Doppler ultrasound technology.Results
We found 48 diphasic waves and 7 threephasic waves. No monophasic waveform was found. Six of seven threephasic waveforms belonged to litters in which perinatal mortality occurred. The peak velocity during ventricular systole S (cm/s), the peak velocity during the ventricular diastole D (cm/s), the velocity during atrial contraction aV (cm/s), the S/D index, the pulsatility index (PI) and the resistance index were measured.Conclusions
All Doppler indices and velocities were significantly correlated with each other (p < 0.05). The number of newborn puppies and the age of bitches were not related to DV vascular indices or flow rate (p > 0.05). Gestational age was proportional to the PI (p < 0.02). Doppler ultrasonography allows the assessment of DV blood flow in canine fetuses during pregnancy. 相似文献6.
Marco Raber 《Journal of Ultrasound》2014,17(3):203-206
Purpose
To study the usefulness of transrectal ultrasound (TRUS) for catheter guidance in cases of early reinsertion after radical prostatectomy (RP).Methods
Since 2007, we have used TRUS for catheter guidance when early reinsertion after RP is required. A preliminary TRUS examination is done to carefully check the state of the vesicourethral anastomosis. The entire catheter insertion, from bulbar urethra to the bladder, is followed step by step by transrectal ultrasound imaging that tracks, while the probe pushes the catheter through a correct entering line. This prevents the incorrect placement of the catheter across the posterior aspect of the anastomosis in a posterior extravesical place.Results
Between 2007 and 2011, 2,165 RPs were performed at reference hospital for prostate cancer. Early catheter reinsertion was required for 56 patients (2.6 %). All procedures were successful. The incidence of vesicourethral stricture after long-term follow-up was not different from that of patients without early recatheterization who were operated with RP in the same period of the study (4.4 vs 4.2 %, respectively; p = 0.47).Conclusions
If early recatheterization is required in patients recently operated with RP, we suggest catheter guidance with TRUS. 相似文献7.
Giovanni Mariano Vitetta Pierluigi Neri Andrea Chiecchio Alessandro Carriero Stefano Cirillo Annalisa Balbo Mussetto Alessandra Codegone 《Journal of Ultrasound》2014,17(1):1-12
Objective
Primary hyperparathyroidism (PHPT) is a common endocrine disorder that can be cured only by parathyroidectomy. Cervical ultrasonography and scintigraphy are the imaging studies most widely used for preoperative localization of the affected glands. The aim of this retrospective comparative study was to define the respective roles of ultrasonography and parathyroid scintigraphy in these cases.Materials and methods
We analyzed 108 patients who had undergone parathyroidectomies for PHPT following cervical ultrasonographic and scintigraphic examinations. The ultrasound examinations were carried out by an expert physician sonographer in 61 cases and by various physician sonographers with different levels of experience in 47 cases. Sonographic and scintigraphic findings were compared with surgical findings and the diagnostic performance of the two imaging methods was evaluated by means of statistical analysis.Results
The operator dependency of ultrasonography was confirmed by marked variations in sensitivity related to the experience of the sonographer. When sonography was performed by an expert, the sensitivity of combined use of the two methods was not significantly higher than that of sonography alone.Conclusions
In expert hands, the diagnostic yield of ultrasound is appreciably superior. It can therefore be used as the main and possibly sole method for preoperative localization of pathological parathyroid tissues. Combined use of ultrasound and scintigraphy is not cost-effective in these cases. Scintigraphy is indicated only when the ultrasound examination produces negative results. 相似文献8.
Hiroshi Takasaki Stephen May Peter J Fazey Toby Hall 《Journal of Manual and Manipulative Therapy》2010,18(3):153-158
Background
The McKenzie management strategy of mechanical diagnosis and therapy (MDT) is commonly used for the assessment and management of spinal problems. Within this system, ‘derangement syndrome’ is the most common classification, for which the conceptual model is an intra-discal displacement. However, the reduction of an intra-discal displacement by MDT has never been documented. The purpose of this study was to compare, using magnetic resonance imaging (MRI), the nucleus pulposus (NP) profiles before and after the use of this approach.Patient characteristics
The patient was a 34-year-old female with a long history of right sided low back and buttock pain classified with ‘derangement syndrome’.Examination
T2-weighted images of the L4–5 disc at initial assessment were compared with that at final assessment 1 month later. Initially, the MRI showed a portion of the NP displaced right and posteriorly towards the side of pain, and an overall NP position in the coronal plane shifted to the left.Intervention
The patient was managed with a 1-month course of the McKenzie management strategy treatment.Outcomes
One month later, the displaced portion of the NP was no longer present and the left-shifted NP was centrally located.Discussion
These intervertebral disc changes coincided with centralization and abolition of symptoms. This case may support the conceptual model of MDT. 相似文献9.
Introduction
To demonstrate the usefulness of ultrasound (US) in quickly and effectively diagnosing the presence of a foreign body in the superficial soft tissues.Materials and methods
A young lumberjack underwent US examination due to pain and swelling of the back of his right hand. These symptoms are often due to the presence of a wooden splinter.Results
On the back of the right hand, US demonstrated a hyperechoic line with acoustic shadowing surrounded by a hypoechoic halo suggesting a foreign body. Next to it in the same area, several hypoechoic areas were observed.Conclusions
US can quickly identify the exact position of a foreign body embedded in the skin and soft tissues; US can furthermore provide information about the inflammatory process and its spreading. 相似文献10.
Purpose
We describe the clinical findings and the results of cerebral imaging studies [ultrasound (US), magnetic resonance imaging (MRI)] in a full-term newborn with tuberous sclerosis (TS) complex. This condition is inherited as an autosomal dominant trait and characterized by hamartomas involving multiple organs. Diagnosis is based on physical examination together with imaging support.Methods
Since the TS complex can result in numerous CNS abnormalities, cerebral US should be used to further characterize this malformation.Conclusion
Sonography is a useful modality for evaluation of the full-term neonatal brain. 相似文献11.
Nina Kolbe Keith Killu Victor Coba Luca Neri Kathleen M. Garcia Marti McCulloch Alberta Spreafico Scott Dulchavsky 《Journal of Ultrasound》2015,18(2):179-185
Background
Point of care ultrasound (POCUS) is a useful diagnostic tool in medicine. POCUS provides an easy and reproducible method of diagnosis where conventional radiologic studies are unavailable. Telemedicine is also a great means of communication between educators and students throughout the world.Hypothesis
Implementing POCUS with didactics and hands-on training, using portable ultrasound devices followed by telecommunication training, will impact the differential diagnosis and patient management in a rural community outside the United States.Materials and methods
This is an observational prospective study implementing POCUS in Las Salinas, a small village in rural western Nicaragua. Ultrasound was used to confirm a diagnosis based on clinical exam, or uncover a new, previously unknown diagnosis. The primary endpoint was a change in patient management. International sonographic instructors conducted didactic and practical training of local practitioners in POCUS, subsequently followed by remote guidance and telecommunication for 3 months.Results
A total of 132 patients underwent ultrasound examination. The most common presentation was for a prenatal exam (23.5 %), followed by abdominal pain (17 %). Of the 132 patients, 69 (52 %) were found to have a new diagnosis. Excluding pregnancy, 67 patients of 101 (66 %) were found to have a new diagnosis. A change in management occurred in a total of 64 (48 %) patients, and 62 (61 %) after excluding pregnancy.Conclusion
Implementing POCUS in rural Nicaragua led to a change in management in about half of the patients examined. With the appropriate training of clinicians, POCUS combined with telemedicine can positively impact patient care. 相似文献12.
Introduction
The peripheral perfusion index (PI) is a noninvasive numerical value of peripheral perfusion, and the transcutaneous oxygen challenge test (OCT) is defined as the degree of transcutaneous partial pressure of oxygen (PtcO2) response to 1.0 FiO2. The value of noninvasive monitoring peripheral perfusion to predict outcome remains to be established in septic patients after resuscitation. Moreover, the prognostic value of PI has not been investigated in septic patients.Methods
Forty-six septic patients, who were receiving PiCCO-Plus cardiac output monitoring, were included in the study group. Twenty stable postoperative patients were studied as a control group. All the patients inspired 1.0 of FiO2 for 10 minutes during the OCT. Global hemodynamic variables, traditional metabolic variables, PI and OCT related-variables were measured simultaneously at 24 hours after PiCCO catheter insertion. We obtained the 10min-OCT ((PtcO2 after 10 minutes on inspired 1.0 oxygen) - (baseline PtcO2)), and the oxygen challenge index ((10min-OCT)/(PaO2 on inspired 1.0 oxygen - baseline PaO2)) during the OCT.Results
The PI was significantly correlated with baseline PtcO2, 10min-OCT and oxygen challenge index (OCI) in all the patients. The control group had a higher baseline PtcO2, 10min-OCT and PI than the septic shock group. In the sepsis group, the macro hemodynamic parameters and ScvO2 showed no differences between survivors and nonsurvivors. The nonsurvivors had a significantly lower PI, 10min-OCT and OCI, and higher arterial lactate level. The PI, 10min-OCT and OCI predicted the ICU mortality with an accuracy that was similar to arterial lactate level. A PI <0.2 and a 10min-OCT <66mmHg were related to poor outcome after resuscitation.Conclusions
The PI and OCT are predictive of mortality for septic patients after resuscitation. Further investigations are required to determine whether the correction of an impaired level of peripheral perfusion may improve the outcome of septic shock patients. 相似文献13.
Anita Srivastava Meldon Kahan Ashifa Jiwa 《Canadian family physician Médecin de famille canadien》2012,58(4):e210-e216
Objective
To evaluate the feasibility and effectiveness of a multifaceted educational intervention to improve the opioid prescribing practices of rural family physicians in a remote First Nations community.Design
Prospective cohort study.Setting
Sioux Lookout, Ont.Participants
Family physicians.Interventions
Eighteen family physicians participated in a 1-year study of a series of educational interventions on safe opioid prescribing. Interventions included a main workshop with a lecture and interactive case discussions, an online chat room, video case conferencing, and consultant support.Main outcome measures
Responses to questionnaires at baseline and after 1 year on knowledge, attitudes, and practices related to opioid prescribing.Results
The main workshop was feasible and was well received by primary care physicians in remote communities. At 1 year, physicians were less concerned about getting patients addicted to opioids and more comfortable with opioid dosing.Conclusion
Multifaceted education and consultant support might play an important role in improving family physician comfort with opioid prescribing, and could improve the treatment of chronic pain while minimizing the risk of addiction. 相似文献14.
Carrie W. Hoppes Aubrey D. Sperier Colleen F. Hopkins Bridgette D. Griffiths Molly F. Principe Barri L. Schnall Johanna C. Bell Shane L. Koppenhaver 《International Journal of Sports Physical Therapy》2015,10(6):910-917
Background
Military personnel and first responders (police and firefighters) often carry large amounts of gear. This increased load can negatively affect posture and lead to back pain. The ability to quantitatively measure muscle thickness under loading would be valuable to clinicians to assess the effectiveness of core stabilization treatment programs and could aid in return to work decisions. Ultrasound imaging (USI) has the potential to provide such a measure, but to be useful it must be reliable.Purpose
To assess the intrarater and interrater reliability of measurements of transversus abdominis (TrA) and internal oblique (IO) muscle thickness conducted by novice examiners using USI in supine, standing, and with an axial load.Study Design
Prospective, test‐retest studyMethods
Healthy, active duty military (N=33) personnel were examined by two physical therapy doctoral students (primary and secondary ultrasound technicians) without prior experience in USI. Thickness measurements of the TrA and IO muscles were performed at rest and during a contraction to preferentially activate the TrA in three positions (hook‐lying, standing, and standing with body armor). Percent thickness changes and intraclass correlation coefficients (ICC) were calculated.Results
Using the mean of three measurements for each of the three positions in resting and contracted muscle states, the intrarater ICC (3,3) values ranged from 0.90 to 0.98. The interrater ICC (2,1) values ranged from 0.39 to 0.79. The ICC values of percent thickness changes were lower than the individual ICC values for all positions and muscle states.Conclusion
There is excellent intrarater reliability of novice ultrasound technicians measuring abdominal muscle thickness using USI in three positions during the resting and contracted muscle states. However, interrater reliability of two novice technicians was poor to fair, so additional training and experience may be necessary to improve reliability.Level of Evidence
2b 相似文献15.
Alexander Grimm Ulrike Teschner Christine Porzelius Katrin Ludewig J?rg Zielske Otto W Witte Frank M Brunkhorst Hubertus Axer 《Critical care (London, England)》2013,17(5):R227
Introduction
Muscle ultrasound is emerging as a promising tool in the diagnosis of neuromuscular diseases. The current observational study evaluates the usefulness of muscle ultrasound in patients with severe sepsis for assessment of critical illness polyneuropathy and myopathy (CINM) in the intensive care unit.Methods
28 patients with either septic shock or severe sepsis underwent clinical neurological examinations, muscle ultrasound, and nerve conduction studies on days 4 and 14 after onset of sepsis. 26 healthy controls of comparable age underwent clinical neurological evaluation and muscle ultrasound only.Results
26 of the 28 patients exhibited classic electrophysiological characteristics of CINM, and all showed typical clinical signs. Ultrasonic echogenicity of muscles was graded semiquantitatively and fasciculations were evaluated in muscles of proximal and distal arms and legs. 75% of patients showed a mean echotexture greater than 1.5, which was the maximal value found in the control group. A significant difference in mean muscle echotexture between patients and controls was found at day 4 and day 14 (both p < 0.001). In addition, from day 4 to day 14, the mean grades of muscle echotexture increased in the patient group, although the values did not reach significance levels (p = 0.085). Controls revealed the lowest number of fasciculations. In the patients group, fasciculations were detected in more muscular regions (lower and upper arm and leg) in comparison to controls (p = 0.08 at day 4 and p = 0.002 at day 14).Conclusions
Muscle ultrasound represents an easily applicable, non-invasive diagnostic tool which adds to neurophysiological testing information regarding morphological changes of muscles early in the course of sepsis. Muscle ultrasound could be useful for screening purposes prior to subjecting patients to more invasive techniques such as electromyography and/or muscle biopsy.Trial registration
German Clinical Trials Register, DRKS-ID: DRKS00000642. 相似文献16.
F. Piscaglia A.G. Tewelde R. Righini A. Gianstefani F. Calliada L. Bolondi 《Journal of Ultrasound》2009,12(1):6-11
Introduction
Safety issues should always be kept in mind when using diagnostic ultrasound, which is associated with potentially hazardous bio-effects, especially with the introduction of new technologies.Aim
To assess the level of awareness and knowledge of safety issues related to the clinical use of ultrasound among physician-members of the Italian National Society for Ultrasound.Materials and methods
A questionnaire with 11 multiple-choice questions was sent to members of the Italian Society for Ultrasound in Medicine and Biology. The answers were forwarded from the Society''s Secretariat to the investigators, who statistically analyzed the data.Results
The mean age of the 105 respondents was 44 years. The most frequent kind of ultrasound examinations (in addition to conventional B-mode) were: Doppler (74%), contrast-enhanced US (43%), and pediatric studies (43%). Only 50–60% of the responders knew the correct definitions of the terms thermal index and mechanical index. Almost all respondents understood the bio-effects reflected by the thermal index, but only a minority knew the most likely organ target of bio-effects related to the mechanical index and what do indicate the units in which the thermal index is expressed. The majority knew that fetuses are at higher risk of damage. Few respondents were able to identify the correct safety statements included in the recommendations of the International Ultrasound Societies.Conclusion
In conclusion, the present findings indicate that greater efforts of National Ultrasound Societies are warranted in disseminating knowledge of the bio-effects of diagnostic ultrasound modalities among operators. 相似文献17.
Nathan Tennyson William M. Mendenhall Christopher G. Morris Emina H. Huang Robert A. Zlotecki 《Clinical Medicine & Research》2012,10(4):224-229
Objective
To evaluate the efficacy of transanal excision (TAE) combined with radiotherapy for rectal adenocarcinoma, assess the ability of pretreatment endoscopic ultrasound (EUS) to predict failures, and determine the prognostic value of downstaging and complete pathological response.Design
Retrospective outcomes study.Setting
Radiation oncology clinic.Participants
Thirty-eight patients with rectal adenocarcinoma.Methods
The medical records of patients treated with radiotherapy from 1998 to 2008 and followed for a median of 5.9 years were reviewed.Results
Kaplan-Meier estimates of freedom from selected endpoints at 5 years after treatment were: overall survival, 79%; cause-specific survival, 91%; local control, 90%; and freedom from distant metastasis, 76%. Seven patients (21%) had eventual abdominoperineal resection or lower anterior resection, four patients had local recurrence, and three patients had incomplete treatment or poor margins. T3 lesions clinically staged by EUS were a predictor of local failure (P=0.0110), but not distant metastasis (P=0.35). Patients with either a pathological or clinical T3 lesion did not have a significantly greater rate of metastasis (P=0.096). Patients who were downstaged did not have a significantly different rate of local recurrence or metastasis. Patients who experienced a complete pathological response did not have a significantly different rate of local control or distant metastasis.Conclusion
Patients with early-stage rectal lesions who undergo preoperative or postoperative radiation and TAE have similar outcomes to those who undergo abdominoperineal resection; local recurrence was higher for patients with T3 lesions when both were compared. Abdominal surgery should be considered for these patients. TAE is reasonable when patients are unwilling or unable to tolerate the morbidity of traditional transabdominal surgery. 相似文献18.
Guido Menozzi Valeria Maccabruni Ermanno Gabbi Giacomo Magnani Elisa Garlassi 《Journal of Ultrasound》2015,18(3):223-227
Purpose
To prospectively evaluate the prevalence of the embolization of the spleen in patients with definite left-sided infective endocarditis (IE) using a contrast-enhanced ultrasound (CEUS).Methods
From March 2012 through September 2013, 18 consecutive patients (9 females and 9 males, aged 21–83 years) evaluated at our hospital and with definite left-sided IE according to the revised Duke criteria were enrolled. All of the patients gave informed written consent and the study was performed in conformity with the ethical guidelines of the Declaration of Helsinki. All of the patients were submitted to a CEUS of the spleen within 10 days after the definite diagnosis of IE. For the CEUS, a blood pool second-generation contrast agent and an ultrasound machine with a contrast harmonic imaging technology were used.Results
The splenic CEUS showed infarctions in 11 patients (61 %) and resulted positive in the 2 patients with negative echocardiography.Conclusions
In this study, CEUS of the spleen, a repeatable and low-cost imaging technique, easily allowed the bedside detection of asymptomatic and even tiny infarctions and showed a high rate of embolization in patients with definite left-sided IE. Therefore, in the setting of IE (possible or definite), CEUS of the spleen has the potential to better define or accelerate the diagnosis itself.Electronic supplementary material
The online version of this article (doi:10.1007/s40477-014-0131-4) contains supplementary material, which is available to authorized users. 相似文献19.
Mei-ling Wiedmeyer Aisha Lofters Meb Rashid 《Canadian family physician Médecin de famille canadien》2012,58(9):e521-e526
Objective
To see if refugee women at a community health centre (CHC) in Toronto, Ont, are appropriately screened for cervical cancer and if there are any demographic characteristics that affect whether they are screened.Design
Chart review.Setting
A CHC in downtown Toronto.Participants
A total of 357 eligible refugee women attending the CHC.Main outcome measures
Papanicolaou test received or documented reason for no Pap test.Results
Ninety-two percent of women in the study sample were either appropriately screened for cervical cancer or had been approached for screening. Eighty percent of women were appropriately screened. Demographic variables including pregnancy, being uninsured, not speaking English, recent migration to Canada, and being a visible minority did not affect receipt of a Pap test after migration in multivariate analyses. Not speaking English was associated with a delay to receiving a first Pap test after migration.Conclusion
The clients at our centre are demographically similar to women who are typically overlooked for Pap tests in the greater Toronto area. Despite belonging to a high-risk population, refugee women in this multidisciplinary CHC were screened for cervical cancer at a higher rate than the local population. 相似文献20.
L.M. Sconfienza F. Lacelli A. Ardemagni N. Perrone M. Bertolotto R. Padolecchia G. Serafini 《Journal of Ultrasound》2010,13(4):143-149