Identifying Factors Important to Patients for Resuming Elective Imaging During the COVID-19 Pandemic

PurposeTo identify factors important to patients for their return to elective imaging during the coronavirus disease 2019 (COVID-19) pandemic.MethodsIn all, 249 patients had elective MRIs postponed from March 23, 2020, to April 24, 2020, because of the COVID-19 pandemic. Of these patients, 99 completed a 22-question survey about living arrangement and health care follow-up, effect of imaging postponement, safety of imaging, and factors important for elective imaging. Mann-Whitney U, Fisher’s exact, χ² tests, and logistic regression analyses were performed. Statistical significance was set to P ≤ .05 with Bonferroni correction applied.ResultsOverall, 68% of patients felt imaging postponement had no impact or a small impact on health, 68% felt it was fairly or extremely safe to obtain imaging, and 53% thought there was no difference in safety between hospital-based and outpatient locations. Patients who already had imaging performed or rescheduled were more likely to feel it was safe to get an MRI (odds ratio [OR] 3.267, P = .028) and that the hospital setting was safe (OR 3.976, P = .004). Staff friendliness was the most important factor related to an imaging center visit (95% fairly or extremely important). Use of masks by staff was the top infection prevention measure (94% fairly or extremely important). Likelihood of rescheduling imaging decreased if a short waiting time was important (OR = 0.107, P = .030).ConclusionAs patients begin to feel that it is safe to obtain imaging examinations during the COVID-19 pandemic, many factors important to their imaging experience can be considered by radiology practices when developing new strategies to conduct elective imaging.     

Literature Review of the Association Between Prenatal Education and Rates of Cesarean Birth Among Women at Low Risk

A review of the literature was performed to explore the association between prenatal education and rates of primary cesarean birth for women at low risk for cesarean birth. Most women who are nulliparous with a singleton fetus of term gestational age and in the vertex position are considered to be at low risk and favorable for a vaginal birth, yet the cesarean birth rate for women at low risk was 25.6% in 2019. It has been suggested that the rise in the cesarean birth rate among low-risk women may not be due to medical indications but, rather, to nonmedical factors, such as a provider’s or woman’s preference or lack of prenatal education. Evidence from this literature review supports the premise that prenatal education classes should be routinely incorporated into maternity care in an effort to reduce cesarean birth rates for the low-risk population.     

导乐陪伴分娩在初产妇分娩中的护理效果分析

目的分析导乐陪伴分娩在初产妇分娩中的护理效果。方法研究时间段:2019年5—12月;研究对象:医院接诊的76例初产妇,根据入院时间的不同进行分组,研究组、对照组各38例,研究组产妇给予导乐陪伴分娩,对照组产妇给予常规护理分娩,干预后评价临床干预效果、自然分娩率、剖宫产率、疼痛程度及产妇心理状况。结果总产程时长[研究组(258.97±168.00)min<对照组(336.78±152.93)min](P<0.05);疼痛程度:干预后[研究组(4.79±0.89)分<对照组(6.31±1.37)分](P<0.05);护理后心理状况:SAS[研究组(20.13±2.74)分<对照组(24.01±4.03)分]、SDS[研究组(20.32±2.53)分<对照组(23.69±5.04)分](P<0.05)。此外,研究组产后出血量和自然分娩率均低于对照组,但差异无统计学意义(P>0.05)。结论导乐陪伴分娩对初产妇具有显著的临床干预效果,既能提高自然分娩率,降低剖宫产率,又能缩短产妇产程,减少产后出血量,同时还能有效缓解产妇疼痛,改善产妇心理状况。     

剖宫产术后的抗凝治疗

产科手术尤其是急诊剖宫产术导致静脉血栓栓塞疾病发病率及病死率呈显著上升趋势，多表现为术后的深静脉血栓形成和肺栓塞，这不仅与手术因素相关，也与大多数合并的病理产科因素相关。术后是否常规抗凝治疗目前尚存在争议，国内亦无大规模临床研究数据支持。本文从临床角度出发，探讨如何评估产科手术后发生血栓的风险，确定抗血栓预防干预的有效时机以及合理的治疗方案。     

中西医结合护理对剖宫产术后乳汁分泌的影响

目的探析对剖宫产产妇采取中西医结合护理的效果。方法本次研究72例剖宫产产妇均为本院2018年3月-2018年11月接收,随机分为2组,对照组(n=36)行常规护理,研究组(n=36)开展中西医结合护理,统计各组护理效果。结果在初乳泌乳始动优良率、母乳喂养、乳汁分泌充足及乳房胀痛发生率方面,研究组均优于对照组,差异有统计学意义(P<0.05)。结论中西医结合护理在剖宫产产妇护理中效果突出,有助于改善产妇术后的乳汁分泌情况,值得推广。     

基于中医传承辅助平台研究儿童腹泻的推拿选穴规律

[目的]基于中医传承辅助平台(V2.0)软件,探讨辨病推拿治疗儿童腹泻病的选穴规律。[方法]收集中国知网数据库、万方数据库、重庆维普数据库1979—2019年文献中关于儿童腹泻病的辨病推拿处方,应用中医传承辅助平台(V2.0)软件,采用该软件的规则分析、改进互信息法等数据挖掘方法,分析40年来小儿腹泻病的辨病推拿处方选穴规律。[结果]儿童腹泻病的辨病推拿处方395个,涉及穴位83个,常用穴位21个,核心穴位组合46个,高频穴位中小儿推拿特定穴占66.67%,最核心组合为脾经、七节骨、大肠经、腹、龟尾、脊柱穴。[结论]辨病推拿治疗儿童腹泻病以健脾化湿、调理大肠气机功效的穴位为主,核心穴位为脾经与大肠经,推荐处方为脾经、七节骨、大肠经、腹、龟尾、脊柱穴。     

妊娠合并肺动脉高压患者剖宫产围产期并发症的危险因素分析

目的探讨妊娠合并肺动脉高压患者剖宫产围产期并发症的危险因素。方法该研究为病例对照研究。回顾性纳入山东大学齐鲁医院、山东第一医科大学附属省立医院、山东省千佛山医院和青岛大学附属医院2010年5月至2020年5月妊娠合并肺动脉高压患者。根据是否发生剖宫产围产期并发症分为并发症组和对照组。收集患者的一般临床资料和辅助检查结果, 记录患者发生围产期并发症的情况。围产期并发症包括心功能恶化、新发心律失常、心脏骤停、术后42 d内全因死亡、产后出血及血栓事件。采用多因素logistic回归模型分析妊娠合并肺动脉高压患者剖宫产围产期并发症的危险因素。结果研究纳入患者167例, 年龄28(24, 32)岁, 其中并发症组47例, 对照组120例。两组患者年龄, 孕周, 初产妇、存在心内分流及接受靶向药物治疗者比例, 左、右心室舒张末期内径差异均无统计学意义(P均>0.05)。与对照组比较, 并发症组患者特发性肺动脉高压者比例较高(P=0.001)、接受全身麻醉的比例较高(P=0.001)、超声心动图估测的肺动脉收缩压较高(P<0.001)、术前世界卫生组织(WHO)功能Ⅲ/Ⅳ级者比例较高(...     

Utility of teledermatopathology for intraoperative margin assessment of melanoma in situ,lentigo maligna type: A 6 year community practice experience

BackgroundAchieving negative margins for melanoma in situ, lentigo maligna type can be challenging, particularly on cosmetically sensitive areas.ObjectiveTo assess the utility of intraoperative frozen section margin assessment using a teledermatopathology system in the treatment of head and neck lentigo maligna.Methods and materialsOver a 6 year period, 96 patients with lentigo maligna had surgical excisions. The margins were assessed intraoperatively with frozen sections prepared in the manner used in Mohs surgery. The surgeon guided the frozen section slides around the margin while a dermatopathologist assessed the margin remotely.ResultsIn 2/96 (2.1%) cases, the safety margin was positive (frozen sections were false negative). In 1 further case (1%) there was a recurrence of the melanoma 13 months following the excision.ConclusionThe described method is effective in treating melanoma in situ, lentigo maligna type with clearance rates similar to previous studies for Mohs surgery.