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1.
《Australian critical care》2022,35(4):408-414
BackgroundClinically significant post-traumatic stress symptoms (PTSS) have been reported in up to a quarter of paediatric intensive care unit (PICU) survivors. Ongoing PTSS negatively impacts children's psychological development and physical recovery. However, few data regarding associations between potentially modifiable PICU treatment factors, such as analgosedatives and invasive procedures, and children's PTSS have been reported.ObjectivesWe sought to investigate the medical treatment factors associated with children's PTSS after PICU discharge.MethodsA prospective longitudinal cohort study was conducted in two Australian tertiary referral PICUs. Children aged 2-16 y admitted to the PICU between June 2008 and January 2011 for >8 h and <28 d were eligible for participation. Biometric and clinical data were obtained from medical records. Parents reported their child's PTSS using the Trauma Symptom Checklist for Young Children at 1, 3, 6, and 12 months after discharge. Logistic regression was used to assess potential associations between medical treatment and PTSS.ResultsA total of 265 children and their parents participated in the study. In the 12-month period following PICU discharge, 24% of children exhibited clinically elevated PTSS. Median risk of death (Paediatric Index of Mortality 2 [PIM2]) score was significantly higher in the PTSS group (0.31 [IQR 0.14–1.09] v 0.67 [IQR 0.20–1.18]; p = 0.014). Intubation and PICU and hospital length of stay were also significantly associated with PTSS at 1 month, as were midazolam, propofol, and morphine. After controlling for gender, reason for admission, and PIM2 score, only midazolam was significantly and independently associated with PTSS and only at 1 month (adjusted odds ration (aOR) 3.63, 95% CI 1.18, 11.12, p = 0.024). No significant relationship was observed between the use of medications and PTSS after 1 month.ConclusionsElevated PTSS were evident in one quarter (24%) of children during the 12 months after PICU discharge. One month after discharge, elevated PTSS were most likely to occur in children who had received midazolam therapy. 相似文献
2.
单中心18726例腹腔镜胆囊切除术并发症分析及预防处理对策探讨 总被引:65,自引:6,他引:59
目的 分析腹腔镜胆囊切除术(LC)的并发症及其影响因素,探讨并发症防治策略。方法 采用回顾性分析法,对自1992年3月至2001年7月在我腹腔镜中心行LC的18726例病人,术中、术后并发症及其发生因素进行分析。结果 术中胆总管损害28例(0.15%),术后胆漏62例(0.33%),腹腔出血6例(0.03%),术后腹腔内脓肿及切口疝7例(0.03%),总计103例,并发症发生率为0.55%。分析其原因与比适应证选择不当及术者对胆道解剖变异等缺乏足够认识等因素有关。结论 胆漏以及胆管损伤是比的主要并发症,精确操作可避免其损伤,术中及时发现和处理,一般预后是良好的。 相似文献
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G. Roglić I. Pavlić-Renar S. šestan-Crnek M. Prašek M. Kadrnka-Lovrenčić A. Radica Ž. Metelko 《Diabetologia》1995,38(5):550-554
Summary The objective of this study was to determine the incidence of insulin-dependent diabetes mellitus (IDDM) in the population of Zagreb, Croatia, during 1988–1992. A centralized diabetes registry was the primary source of data, while secondary sources were used to assess ascertainment. A total of 282 new cases of IDDM were diagnosed in the study period, the primary and secondary sources identifying annually 93–100% of the cases. The annual incidence rate ranged from 5.6 per 100,000 to 6.6 per 100,000. Early fatality in persons older than 50 years was the major cause of underascertainment. The incidence peaked in the 10–14 years age group (12.4 per 100,000), and remained stable after age 24 years. Males had a significantly higher incidence in the 5–9 and 24–44 years age groups. In the 45–54 years age group, females had a significantly higher incidence. No seasonality was observed. Despite the war conditions in Croatia, the low overall IDDM incidence rates did not change significantly during the study period.Abbreviations IDDM
Insulin-dependent diabetes mellitus
- DKA
diabetic ketoacidosis 相似文献
5.
6.
CT features of gastric lymphoma 总被引:3,自引:0,他引:3
The gastrointestinal tract is the most frequent site of extranodal involvement by lymphoma and stomach is the most frequently
involved. The incidence of gastric lymphoma appears to be rising as that of adenocarcinoma is declining. It produces a spectrum
of radiologic appearances and its distinction from adenocarcinoma is difficult since their findings frequently overlap. The
aim of this article is to present pictorially a spectrum of CT findings of the gastric lymphoma.
Received: 11 August 1998; Revision received: 26 March 1999; Accepted: 30 June 1999 相似文献
7.
《Patient education and counseling》2017,100(12):2269-2274
ObjectiveTo evaluate residents’ ability to engage standardized patients in informed decision making during a pregnancy loss scenario.MethodsForty patient encounters between interns and standardized patients were coded to assess informed decision-making practices, exploration of unexpressed concerns, and support provision.ResultsInterns engaged in minimum informed decision making but did not address all of the communicative elements necessary for informed decisions, and most elements were only partially addressed. Patients in this study did not receive information about all management options, their concerns were not addressed, and there was limited support communicated for their decision.ConclusionThis study offers an initial assessment of a communicative approach to evaluate and improve decision making during early pregnancy loss. A comprehensive approach to making informed decisions must include discussion of all management options, exploration of patient preferences and concerns, and support for the patient’s decision.Practice implicationsPhysicians could benefit from communication skills training to communicate more effectively with patients to help them make more informed decisions. 相似文献
8.
IntroductionTo evaluate the feasibility of testis diffusion tensor imaging (DTI), to determine normative apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values and to assess the efficacy of DTI in characterizing testicular pathology.Materials and methodsFifty-six men underwent MRI of the scrotum, including DTI. Parametric and non-parametric statistical tests were used to compare the ADC and FA between the cranial, middle and lower thirds of normal testis and between the bilateral testicular thirds. Comparison between the ADC and FA of normal testis, malignant and benign testicular lesions was performed.ResultsNo significant differences of the ADC and FA in normal testis between the cranial, middle and lower thirds and between the bilateral testicular thirds were found. ADC was significantly lower in malignancies compared to normal testis (P = 0.006) and benign testicular lesions (P = 0.006). FA was significantly higher both in malignancies (P = 0.001) and benign lesions (P < 0.001) compared to normal testis. FA in malignancies did not differ from FA in benign lesions (P = 0.221)ConclusionsThis study shows the feasibility of testis DTI. Both ADC and FA significantly differ between testicular lesions and normal testis, although FA did not show an incremental diagnostic value compared to ADC in lesion differentiation. 相似文献
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Hossein Ebrahimi Ali Abbasi Hossein Bagheri Mohammad Hasan Basirinezhad Sara Shakeri Reza Mohammadpourhodki 《Patient education and counseling》2021,104(1):130-135
ObjectiveThis study aimed to assess the effect of peer education on the quality of life and self-care behaviors of patients with myocardial infarction.MethodsIn this clinical trial, 70 patients with myocardial infarction meeting the inclusion criteria were assigned to experimental (n = 35) or control (n = 35) groups using block randomization. Patients in the intervention group received two one-hour training sessions on the third day after myocardial infarction during the CCU stay along with routine care. Education intervention was performed by peers. The control group will follow routine care. All patients selected were assessed using McNews' quality of life questionnaire and Miller self-care questionnaire, respectively before the intervention and also one month after discharge. Chi-square and t-test were used to analyze the data.ResultsAfter the intervention, the mean of quality of life and the mean score of self-care behaviors in the experimental group were significantly higher compared to the control group.ConclusionsAccording to the results, to improve the quality of life and promote the self-care behaviors in such patients, using peer education along with healthcare professionals is recommended.Practice ImplicationThis patient education approach had a significant impact on quality of life and self-care behavior. 相似文献