Communication between an occupational physician and other medical practitioners--an audit

Four hundred and seventy-two consecutive referral episodes relatingto 386 patients attending the Occupational Health Departmentof a general teaching hospital were analyzed to evaluate thefrequency, content and effect on management of communicationsbetween the occupational physician and other doctors. In all,250 episodes (53%) were associated with such a communication.The likelihood of a communication was strongly influenced byreason for referral, particularly in respect of long or shortterm sickness absence; univariate odds ratios (OR)=10.58, 95%Cl=8.13–27.08) and 2.65, 95% Cl=1.55–4.60) respectively;a medical diagnosis of psychiatric illness (OR=3.17, 95% Cl=1.69–5.97));and by number of consultations. Communication was also morelikely when the occupational outcome was ill health retirement,rehabilitation in work or modified work. Ninety-eight per centof specific requests for information or an opinion eliciteda reply. Information received from other doctors influencedthe occupational health physician's management in 52 referralepisodes (20%). Specific action by GPs as a result of communicationwas documented in 54 and by specialists in 37 episodes. Theimportance of communication between occupational health physicianand other doctors in the occupational health process is confirmed.     

National survey on the management of primary hyperparathyroidism by Swiss endocrinologists

Background From the endocrine surgeon’s perspective, it is important to know how endocrinologists manage patients with primary hyperparathyroidism (pHPT). The aim of this survey was to evaluate the preoperative diagnostic workup and referral pattern for parathyroidectomy by Swiss endocrinologists. Materials and methods The survey was conducted by mailing a questionnaire to all members of the Swiss Society for Endocrinology and Diabetes in spring 2005. Results The questionnaire was sent back by 68 of 124 endocrinologists (55%). The median annual case volume of patients with pHPT was 6 (range 1–50). The mean fraction of these patients referred for surgery was 59 ± 24%. This fraction was significantly higher in the German-speaking part of Switzerland than in the French-speaking part (67 ± 21% vs 51 ± 27%). When considering surgery for asymptomatic pHPT, 62% of the endocrinologists rely routinely on the recommendations of the NIH consensus conference and 86% on the subsequent guidelines of the workshop in 2002. Sixty-seven percent of the endocrinologists routinely perform localization studies before possible referral for surgical exploration. Typically, they consisted of an ultrasonography of the neck (93%) and a ^99mTc-MIBI scintigraphy (80%). The impact of the availability of a minimally invasive surgical procedure on the number of patients referred for surgery seems to be considerable. Sixty-one percent of the participants would expand the indication for surgery if the operation could be done by a limited surgical approach. Conclusions In a relevant fraction of patients with pHPT, endocrinologists still do not regard curative therapy as mandatory. Surprisingly, there are significant cultural differences concerning referral patterns to surgery between the German-speaking and the French-speaking parts of Switzerland. Minimally invasive procedures seem to lower the threshold for referral for surgical therapy. This work was presented at the 2nd Biennial Congress of the ESES, May 2006, Krakow, Poland.     

针刺治疗前列腺痛疗效观察

目的评价针刺治疗前列腺痛的疗效。方法选用前列腺痛患者60例,随机分成针刺组（n=30）和药物组（n=30）,观察两组疗效。结果针刺组治愈5例,显效12例,有效11例,无效2例,总有效率93.3%;药物组治愈2例,显效8例,有效13例,无效7例,总有效率76.7%。针刺组总有效率优于药物组（P〈0.05）,且针刺组在降低NIH-CPSI总积分及疼痛症状、尿路症状、生活质量各亚评分方面均优于药物组。结论针刺是治疗前列腺痛的有效方法。     

基于BIS指数的麻醉给药系统研究设计

麻醉给药研究的关键问题之一是如何保证麻醉药品在人体效应室中的理想浓度。以药代动力学为基础的靶控输注（TCI）是一种可实现的方法,基于BIS指数的实时闭环麻醉给药系统实时控制靶控输注给药可以获得理想的麻醉效果。本文对这一麻醉给药系统的研究提出临床工程设计方案,并加以实现。     

正确饮水与安全用药

目的：探讨服药时饮水量及水的成分对所服药物的影响。方法：通过文献查阅和总结．对服药时需多饮水的药物、服药时需少饮水及不需饮水的药物、服药时对水的成分要求分别进行阐述。结果：服药时正确饮水，才能发挥最大治疗作用。结论：药师和医生应重视服药时饮水对疾病治疗的影响，给予患者正确的指导，保证患者用药安全、有效达到预期的治疗目的。     

Data Bank and Consulting System for Medical Management of Patiens with Acute Radiation Sickness

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Promoting inter-agency collaborátion in child services

Summary Effective collaboration between agencies is often difficult to achieve. Children and their families/carers, who have complex therapeutic needs, present particular difficulties in that agencies need to work together, if they are to produce a co-ordinated and integrated package of care. A Multi-Agency-Consultation-Team (MACT) was set up in an attempt to overcome some of these problems of interagency co-operation. This paper describes the protocol, types of children referred and the recommendations made by the team. Follow-up of these children at 4 months suggests that a MACT does have a role to play in developing high quality services.     

Dixyrazine premedication for cataract surgery. A comparison with diazepam

Peroral dixyrazine (15–30 mg, n = 50) and diazepam (4–10 mg, n = 50) were used as premedicants for geriatric patients having cataract surgery under regional block. Compared to the diazepam patients, a larger number of the dixyrazine medicated patients appeared anxious, and there was a statistically significant difference between the groups, when summing up changes in anxiety throughout the study period. The dixyrazine patients needed more frequent supplementation with intravenous sedative drugs, compared with their diazepam counterparts. Peroral dixyrazine is an applicable choice for calm patients, when only slight sedation, or avoidance of somnolence are required.     

综合医院精神科会诊患者失眠的临床研究

目的：探讨综合医院精神科会诊患者失眠的临床特征及与其它精神障碍的关系。方法：对168例精神科会诊患者进行分析。结果：128例(76、2％)会诊患者有失眠．其中61．7％(79／128)为慢性失眠。原发性失眠仅占5．5％(7／128)，85．1％(109／128)是与其它精神障碍有关的失眠。常见的精神障碍诊断为焦虑障碍、心境障碍和谵妄。60．9％的失眠患者在会诊前得到了处理。结论：应对临床医师进行精神卫生教育，提高他们对失眠等常见精神障碍的识别和处理能力。