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1.
本文报告3例在疼痛诊疗过程中的误诊与误治,原发病分别为病灶未明确的颈椎癌转移、脊椎结核腰大肌间沟寒性脓肿与腰骶椎恶性肿瘤,分别被误诊为颈椎病、腰肌劳损与腰肌劳损,幸及时发现,纠正了错误的治疗。因此应强调从事疼痛业务必须有扎实的通科基础,严格的检查流程与认真的工作态度。 相似文献
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目的:探讨妊娠黄体瘤(LP)的误诊原因。方法:对1例典型LP病例进行全面病理学检查和组化及免疫组化染色,与正常卵巢黄体进行对比分析,并复习文献。结果:LP均发生于妊娠后期,临床无明显自觉症状,其病理形态学、组织学、免疫组化反应与正常卵巢黄体相似。多在剖腹产时偶然发现而误为卵巢肿瘤。结论;LP为妊娠后期卵巢黄素化细胞的结节状增生,并非真性肿瘤。妊娠期出现卵巢明显增大,应首先考虑到本病的可能性。必要时术中可作活检,以避免误切卵巢。 相似文献
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《Gastroenterologia y hepatologia》2020,43(5):233-239
IntroductionErrors are very common in daily clinical practice; however, they can be prevented. Our aim was to identify the most common errors in the outpatient management of inflammatory bowel disease (IBD) patients.Material and methodsPatients diagnosed with IBD, being treated at our IBD Unit and who were referred for a second opinion were consecutively enrolled. Data on the strategies implemented by their previous physicians were obtained. These strategies were compared with the currently recommended diagnostic and therapeutic procedures.ResultsSeventy-four IBD patients were enrolled. Prior to care in our Unit, screening for tobacco use had been performed in 50% of Crohn's disease patients, while smoking cessation counselling had been provided in 29%. At the time of IBD diagnosis, the hepatitis B virus immunization status had been investigated in 16% of the patients, the hepatitis C virus status in 15%, and the varicella status in 7%. Seven percent of the patients had been vaccinated against hepatitis B virus, and 3% against influenza, tetanus and pneumococcus. Sixty-seven percent of the patients with an indication for use of 5-aminosalicylic acid and 37% of those with an indication for immunosuppressants had received the indicated drug.DiscussionErrors in the outpatient management of IBD patients are very common and relevant. 相似文献
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This is the third in a short series of papers on measurement theory and practice with particular relevance to research in nursing, midwifery, and healthcare. In this paper I demonstrate how the decisions we make regarding the post hoc treatment of our measurements impact the quality of our data and influence the validity of the inferences we draw from them. I address two variations of this practice, pooling data over response options found on self-report measures, and transforming measurements of continuous variables, such as age, into ranges or ordered categories. The problems inherent in this practice are examined using concepts from information theory. Pooling more precise measurements into less precise ones creates errors of discreteness that introduce unpredictable (positive or negative) bias in our results. 相似文献
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Hereditary Angioedema Due to C1-Inhibitor Deficiency in Romania: First National Study,Diagnostic and Treatment Challenges 下载免费PDF全文
Gabriella GabosValentin NadasanEniko MihalyDaniela Dobru 《Iranian journal of immunology : IJI》2020,17(3):226-235
Background: Hereditary angioedema (HAE) is a rare genetic potentially life-threatening disease characterized by episodic non-pruritic subcutaneous and submucosal edema attacks in different parts of the body. Objective: To assess the status of Romanian HAE patients after the recent introduction of a new therapy through a nationwide program. Methods: This cross-sectional observational study included patients from the Romanian HAE Registry. Results: The study included 84 patients with HAE type I (91.7%) and type II (8.3%). The mean delay in diagnosis was 2.4 years in children and 16.7 years in adults (p=0.019). Stress and tiredness were the most frequent trigger factors. The majority of the HAE episodes involved subcutaneous (89.3%), abdominal (77.4%), genital (51.2%), facial (41.7%), and laryngeal (39.3%) symptoms during the preceding 12 months. One or several misdiagnoses were reported in 83.33% patients and 44.1 % of the patients were subjected to or proposed unnecessary surgery during abdominal episodes. Plasma-derived C1-INH (pdC1-INH) and recombinant C1-INH (rhC1-INH) were respectively used in 10 (11.9%) and 13 (15.5%) of the HAE patients for life-threatening attacks over the past 12 months. Fortythree (51.19%) patients practiced home treatment with subcutaneous injection of the bradykinin B2-receptor antagonist for acute HAE attacks. Conclusion: The significantly lower delay observed in children suggests an improvement in the awareness of C1-INH-HAE among physicians in recent years. The management of HAE in Romania has been somewhat enhanced as the majority of HAE patients have recently gained access to pdC1-INH, rhC1-INH, and bradykinin B2-receptor antagonist. 相似文献
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Giorgio Minoli Paolo Borsato Enrico Colombo Aurora Bortoli Tino Casetti Giovanni de Pretis Luca Ferraris Ivano Lorenzini Alberto Meggio Rudy Meroni Lucia Piazzi Vittorio Terruzzi 《Digestive and liver disease》2012,44(11):914-918
Background
Not much is known about errors and near misses in digestive endoscopy.Aims
To verify whether an incident report, with certain facilitating features, gives useful information about unintended events, only excluding errors in medical diagnosis.Method
Nine endoscopy units took part in this cross sectional, prospective, multicentre study which lasted for two weeks. Members of the staff were required to report any unintended, potentially dangerous event observed during the daily work. A form was provided with a list of “reminders” and facilitators were appointed to help.The main outcome measurements were type of event, causes, corrective interventions, stage of occurrence in the workflow and qualification of the reporters.Results
A total of 232 errors were reported (two were not related to endoscopy). The remaining 230 amount to 10.3% of 2239 procedures; 66 (29%) were considered errors with consequences, 164 (71%) “near misses”. There were 150 pre-operative errors (65%), 22 operative (10%) and 58 post-operative (25%). Corrective interventions were provided for 60 cases of errors and 119 near misses. Most of the events were reported by the nurses (106 out of 232, 46%).Conclusions
Short-term incident reporting focusing on near misses, using forms with lists of “reminders”, and the help of a facilitator, can give useful information on errors and near misses in digestive endoscopy. 相似文献9.
目的:对静配中心出现差错的原因进行总结,为今后进一步防范差错提供思路。方法:根据2012年2月-2013年11月我院静配中心差错登记本及工作量统计表,计算和比较各个不同时期的差错率,并对各配置环节出现的各类差错分类汇总,分析比较。结果:我院静配中心2012年2月-2013年11月共配置成品输液1124074袋,发生差错141袋,差错率为0.125‰,自运行以来差错发生率呈下降趋势,在各环节的各种差错中,退药处理失误、加药错误和用错注射器占有较大比例。结论:有针对性地采取一系列的防范措施可降低静配中心差错率,静配中心对于差错的防范是一项需要持续改进,常抓不懈的重要工作。 相似文献
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采用回顾性研究法,对2007年~2012年江西省血液中心发生的219例差错进行归纳和分析发现:混合因素、工作疏忽或责任心欠缺、外界因素、违反制度或操作规程、知识欠缺等是差错发生的主要原因,差错主要发生地点为采血车和献血单位。采供血机构可通过实施全面质量管理,加强培训和质量监督,改善工作环境,设计科学合理的工作流程等进行改进。 相似文献