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61.
62.
《Best Practice & Research: Clinical Rheumatology》2019,33(3):101418
In this chapter, we provide an overview of neuroimaging studies in chronic pain. We start with an introduction about the phenomenology of pain. In the following section, the application of functional and structural imaging techniques is shown in selected chronic pain syndromes (chronic back pain, fibromyalgia syndrome (FMS), phantom limb pain, and complex regional pain syndrome (CRPS)), and commonalities and peculiarities of imaging correlates across different types of chronic pain are discussed. We conclude this chapter with implications for treatments, with focus on behavioral interventions, sensory and motor trainings, and mirror and motor imagery trainings. 相似文献
63.
Jan F.M. Verbeek Chris H. Bangma Charlotte F. Kweldam Theodorus H. van der Kwast Intan P. Kümmerlin Geert J.L.H. van Leenders Monique J. Roobol 《Urologic oncology》2019,37(2):138-144
Introduction
The use of risk calculators predicting clinically significant prostate cancer (csCaP) on biopsy reduces unnecessary biopsies and overdiagnosis of indolent disease compared to a Prostate Specific Antigen (PSA) strategy. Updating these tools using more specific outcome measures and contemporary predictors could potentially lead to further reductions. Our objective was to assess clinical impact of the 4 kallikrein (4K) score, the Rotterdam Prostate Cancer Risk Calculator (RPCRC), and the combination of both for predicting csCaP based on the latest International Society of Urological Pathology grading system and cribriform growth pattern.Materials and methods
Our prospective cohort consisted of 2,872 men from the first screening round in the European Randomized Study of Screening for Prostate Cancer Rotterdam; biopsy indication PSA ≥ 3.0. The predictive performance of the 4Kscore, RPCRC, and the combination of RPCRC with 4Kscore were assessed with area under the receiver operator characteristic curve (AUC) and calibration plots. Decision curve analysis was used to evaluate the reduction of unnecessary biopsy and indolent CaP.Results
The csCaP was present in 242 (8%) men, and indolent CaP in 578 (20%). The 4Kscore and RPCRC had similar high AUCs (0.88 vs. 0.87; P?=?0.41). The 4Kscore-RPCRC combination improved AUC to 0.89 compared to 4Kscore (P < 0.01) and RPCRC (P < 0.01). The RPCRC and 4Kscore reduced the number of Bx with 42 and 44, respectively, per 100 men at risk compared to a ≥PSA 3.0 strategy without increasing missed csCaP. The RPCRC-4Kscore combination resulted in a slight additional net reduction of 3.3 biopsies per 100 men.Conclusions
The RPCRC and 4Kscore had similar reductions of unnecessary biopsies and overdiagnosis of indolent disease. Combination of both models slightly reduced unnecessary biopsies further. Gain in net benefit must, however, be weighed against additional costs and availability of tests. 相似文献64.
推行分级诊疗是深化医药卫生体制改革的核心战略,公立医院为了适应分级诊疗的推行必须在实践过程中对相关的措施进行调整。通过分析部分省份在分级诊疗推行过程中公立医院进行的相关改革情况,针对公立医院在分级诊疗推行过程中存在的难以有效下沉医疗资源、信息化建设不到位和分级诊疗推行缺乏持久动力等问题,提出了加强医院内部管理、加强信息化建设并发展高新技术以及完善激励机制等措施,使公立医院在分级诊疗过程中发挥更重要的作用。 相似文献
65.
Introduction
Breast cancer incidence increases from the age of 30 years. As this age range coincides with that in which women usually pursue pregnancy, undergoing medical examinations for conditions such as breast cancer is a concern, especially when pregnancy is uncertain during the first eight weeks. Moreover, in this age range, breast often exhibits a high density, thus compromising diagnosis. For such density, digital breast tomosynthesis (DBT) provides a more accurate diagnosis than 2D mammography given its higher sensitivity and specificity. However, radiation exposure increases during DBT, and it should be determined.Methods
We determined the entrance surface dose, scattered radiation dose, and average glandular dose (AGD), which can be mutually compared following an international protocol. Using our proposed method, the distribution of scattered radiation can be easily and quickly obtained with a minor load to the equipment. Then, we can determine the indoor scattered radiation and surface dose on patients during DBT.Results
We obtained a maximum AGD of 2.32 mGy. The scattered radiation was distributed over both sides with maximum of approximately 40 μGy, whereas the maximum dose around the eye was approximately 10 μGy.Conclusion
By measuring doses using the proposed method, a correct dose information can be provided for patients to mitigate their concerns about radiation exposure. Although the obtained doses were low, their proper management is still required. Overall, the results from this study can help to enhance dose management for patients and safety management regarding indoor radiation. 相似文献66.
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目的:检测可手术非小细胞肺癌患者术前血浆中VEGF、sVEGFR-1的表达水平,并分析其与临床病理资料和长期生存的关系。方法:收集98例可手术非小细胞肺癌患者术前静脉血,用ELISA方法检测血浆中VEGF和sVEGFR-1的表达水平,并分析其表达水平与患者临床病理资料和长期生存之间的关系。结果:可手术非小细胞肺癌患者术前血浆中VEGF、sVEGFR-1的表达水平与患者的临床病理资料没有相关性,但是多因素生存分析中,年龄、TNM分期和VEGF/sVEGFR-1比值是可手术非小细胞肺癌患者长期生存的独立预后因子。结论:血浆VEGF/sVEGFR-1比值与可手术非小细胞肺癌患者的长期生存相关,该比值在非小细胞肺癌的意义值得进一步深入研究。 相似文献
70.
邢周雄 《中国继续医学教育》2020,(8):22-24
目的研究并分析Sandwich教学法应用于ICU临床实习阶段的临床价值及效果。方法选取时间段为2017年5月—2018年5月70例在本院ICU临床实习生作为研究对象,以数字表法随机分为常规组(35例)与研究组(35例),常规组采用常规带教实习教学方法,研究组实施Sandwich教学法,对两组实习生的教学效果展开对比。结果研究组的考试成绩、课堂活跃度、学生参与教学的主动性、学习积极性等均优于常规组,差异有统计意义(P<0.05)。结论ICU临床实习阶段采用Sandwich教学法,可以有效提升ICU实习生教学效果,提升实习生知识掌握水平和学习能力,应用价值显著。 相似文献