乳头溢液514例分析

目的 :探讨乳头溢液的病因和诊断方法 ,有效降低乳腺疾病的发生。方法 :采用乳头溢液涂片检查对 5 14例乳头溢液病例进行回顾性分析。结果 :乳腺导管内乳头状瘤 31.13% ,乳腺囊性小叶增生 2 2 .5 7% ,乳腺癌 14 .78% ,导管扩张症 13.0 4 % ,乳腺炎 12 .4 5 % ,其他 6 .0 3%。结论 :乳头溢液脱落细胞学检查是乳头溢液病因及诊断的首选检查 ,近红外线扫描检查有助于诊断。半数以上≥ 5 0岁乳头溢血患者是乳腺癌患者。早诊、早治溢液性乳腺疾病是防止乳腺癌的重要措施。     

乳头溢液的乳管造影诊断

目的 :为进一步提高乳腺导管系统疾病的 X线诊断水平。方法 :回顾性分析 83例乳头溢液患者的钼靶 X线检查资料 ,所有病例均经临床检查、钼靶 X线平片摄影、乳腺导管造影检查及病理学检查确诊。结果 :肿瘤性疾病占 6 3.86 % ,包括导管内乳头状瘤、导管内乳头状癌、导管癌 ,其中以导管内乳头状瘤最多见 ,占 4 6 .99%。非肿瘤性疾病占 36 .14 % ,包括导管扩张、导管扩张并慢性炎症、乳腺囊肿、小叶增生 ,其中以导管扩张最多见 ,占 18.0 7%。结论 :掌握乳腺导管解剖形态和病变的 X线特征对正确诊断导管内疾病很有价值     

儿童后发性白内障Nd:YAG激光治疗的并发症及其对策分析

目的 探讨Nd：YAG激光治疗儿童后发性白内障的临床效果，重点分析激光治疗中出现的并发症及其处理对策。方法 对儿童后发性白内障40例(52只眼)行Nd：YAG激光后囊切开术，术后随访3～12月，观察并分析术后视力变化和并发症情况。结果 激光截囊成功率为100％，术后视力有不同程度提高。并发症包括人工晶状体损伤(3．8％)、玻璃体前界膜破裂(15．4％)、葡萄膜炎反应(11．5％)、高眼压(9．6％)等。结论 Nd：YAG激光治疗儿童后发性白内障简便有效，能明显提高视力，只要操作得当，聚焦准确，掌握好击射能量等，就能有效避免并发症的发生。     

阴道分泌物的细菌培养及耐药性分析

目的探讨细菌性阴道炎患者阴道分泌物中的病原菌分布及对抗生素的耐药情况。方法对阴道分泌物进行细菌培养和药敏试验,并对结果进行统计学分析。结果从145例阴道分泌物中共检出细菌115株,阳性率为79.3%(115/145)。其中以表皮葡萄球菌27.0%(31/115)、中间葡萄球菌20.9%(24/115)和金黄色葡萄球菌13.0%(15/115)的构成比最高。药敏结果显示:葡萄球菌对万古霉素全部敏感,对磷霉素、阿米卡星和利福平的耐药性最低,对青霉素、四环素、红霉素和苯唑西林的耐药性最高。结论阴道分泌物中病原菌种类较多,以葡萄球菌为主且耐药性较强。病原菌检查和药敏试验对临床诊断和治疗具有重要作用。     

单纯乳头溢液的诊治体会(附64例报告)

目的总结单纯性乳头溢液的诊断和治疗经验。方法对64例单纯性乳头溢液的诊断治疗进行回顾性分析。结果乳腺彩超及选择性乳管造影术对本病均有较高的诊断价值，阳性率分别为66．67％和71．88％。病变乳管内置管美蓝注射有助于病灶的探查和切除。结论乳腺彩超及选择性乳管造影对乳头溢液的诊断有很重要意义，通过美蓝指示行病变区乳腺区段切除安全有效。     

北京市2002年预防接种后不良反应分析

为评价所使用疫苗的安全性 ,收集了北京市 2 0 0 2年的预防接种后不良反应 (AEFI)资料进行分析。结果显示 :在所使用的 17种生物制品中 ,有 13种出现AEFI,主要发生在小年龄段人群 ,≤ 1岁发生数占总数的 6 4 4 %。在 4 5例AEFI中 ,特异性反应 30例 ,其中 2 8例为Ⅰ型变态反应。目前北京市AEFI发生率维持在较低水平 ,提高疫苗生产工艺和接种人员业务素质 ,对于降低AEFI发生率和维持公众信任非常重要。     

Opportunities for Improving Post-Hospital Home Medication Management Among Older Adults

SUMMARY

Effective post-hospital home medication management among older adults is a convoluted, error-prone process. Older adults, whose complex medication regimens are often changed at hospital discharge, are susceptible to medication-related problems (e.g., Adverse Drug Events or ADEs) as they resume responsibility for managing their medications at home. Human error theory frames the discussion of multi-faceted, interacting factors including care system functions, like discharge medication teaching that contribute to post-hospital ADEs. The taxonomy and causes of post-hospital ADEs and related risk factors are reviewed, as we describe in high-risk older adults a population that may benefit from targeted interventions. Potential solutions and future research possibilities highlight the importance of interdisciplinary teams, involvement of clinical pharmacists, use of transitional care models, and improved use of informational technologies.     

Participation in the Chronic Phase of Stroke

Abstract

Background: Participation is a multidimensional concept, consisting of an objective and a subjective dimension. Many studies have focused on determinants of only 1 dimension of participation post stroke. Objective: To describe participation (both objective and subjective) and to determine how physical and cognitive independence and subjective complaints (pain, fatigue, and mood) influence participation in community-dwelling stroke survivors in the Netherlands. Methods: The Utrecht Scale for Evaluation of Rehabilitation (USER) measures physical and cognitive independence and subjective complaints. USER-Participation measures 3 dimensions of participation: frequency (objective perspective), restrictions (subjective perspective), and satisfaction (subjective perspective). Spearman correlations and backward linear regression analyses were used to analyze associations between the 3 USER-Participation scores with demographics, stroke characteristics, physical and cognitive independence, and subjective complaints. Results: Of the 111 participants, 48.5% returned to work post stroke, but mostly for only 1 to 16 hours a week. Experienced participation restrictions were most prevalent in physical exercise, chores in/around the house, housekeeping, and outdoor activities. On average, participants were relatively satisfied with their participation, but dissatisfaction occurred in cognition, activities outdoors, and work/housekeeping. Regression analysis revealed that objective participation was determined by physical and cognitive independence, age, and education, whereas subjective participation was determined by physical and cognitive independence, fatigue, and mood. Conclusions: Most participants experienced participation problems, despite relatively good physical recovery. In addition to physical and cognitive factors, subjective complaints of persons with stroke should be addressed in the rehabilitation program.     

Professional Burnout:

This paper attempts to answer the question of why social caseworkers have ongoing supervision by exploring the historical evolution of social work supervision. Supervision has withstood the many changes in the field since its beginning in the late 1800s and has been reinterpreted to fit the prevailing theories guiding practice, thus avoiding obsolescence. Supervision began as an educational device, then evolved into a practice tool, later became a therapeutic method, and then became a separate entity from therapy.     

Pilot of the Patient Concerns Inventory – Ward Discharge in Patients following major reconstructive surgery for head and neck cancer

Planning discharge from hospital following microvascular free-tissue surgery can be complex and challenging. Planning involves the patient, carers, and multiple health professionals. Poor communication and expectations can delay discharge or give a suboptimal discharge process. It was hypothesised that prompt-list modelled along the principals of the Patient Concerns Inventory (PCI) could be help in discharge planning. The aim of this study was to define the items and format of a PCI-Ward Discharge (PCI-WD) and undertake a small pilot. Items appropriate for the PCI-WD were formulated through discussion with patients, carers, ward staff, Head and Neck Clinical Nurse Specialists, and clinicians. The pilot took place over three months from December 2019 through to February 2020. Audit approval was given by the hospital Audit Department. The PCI-WD comprises 43 items. Items from existing PCIs for use at diagnosis and follow-up consultations were reduced in number and 38 new or modified items added; six treatment related, five social care and social well-being, four psychological, emotional, and spiritual well-being, seven physical and functional well-being, and 16 discharge related. The pilot involved 14 free-tissue transfer patients, seven male, seven female, with an age range of 57 to 87 and a mean age of 72. Eight PCI-WD were returned. PCI-WD items identified most frequently were ‘surgery site other than head/neck’, ‘when do I come back to hospital’, ‘dental check-up/oral health care’ and ‘diet/eating’. Early findings suggest that PCI-WD could be a useful tool in aiding the discharge process. Further evaluation is required.