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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
4.
Abstract It is well established that thrombolytic therapy increases the risk of secondary intracerebral hemorrhage in ischemic stroke
patients. However, the term “intracerebral hemorrhage” (ICH) covers a wide spectrum from tiny spots of blood to massive space-occupying
hematoma. We will review the etiology and clinical consequences of secondary hemorrhage after thrombolysis in ischemic stroke
patients and discuss the ability of magnetic resonance imaging (MRI) to predict this phenomenon. MRI is a highly sensitive
tool for detection of hemorrhagic transformation after ischemic stroke. The definitions of a so-called symptomatic hemorrhage
after ischemic infarction differ considerably and will also be described. Attributing a causal relationship of a clinical
deterioration to a secondary hemorrhage is not easy and should be only addressed when it exceeds at least 30% of the infarct
volume. In other patients, secondary hemorrhage might be regarded as side effect of reperfusion within the region with the
most severe perfusion deficit. Cerebral microbleeds (CMBs) are a frequent finding in patients with leukoaraiosis and appear
to be a general marker of various types of bleeding- prone small vessel disease and a predictor of recurrent vascular events.
Current data do not support the hypothesis that the detection of CMBs is a useful diagnostic criterion for the exclusion of
patients with CMBs from thrombolytic therapy. However, an increased risk for the rare patients with numerous CMBs can not
be ruled out.
相似文献
5.
Sarala Rajajee Malathi Sathyasekaran Janani Shankar Latha Dhathathri Anandnathan 《Indian journal of pediatrics》2002,69(10):821-822
A 5-year-old boy presented with history of failure to thrive from infancy. There was a history of one sibling death due to
similar problems and history of severe abortions in the mother. Routine examination of peripheral smear revealed more than
50% acanthocytes. Based on this tests were streamlined to doing lipid profile and Lipo protein electrophoresis which revealed
hypolipidemia and absent Β hypo protein band. Jejuna) mucosal biopsy confirmed the diagnosis of A Beta Lipo proteinemia which
revealed lipid laden enterocytes. This case illustrates the importance of simple tests like peripheral smear examination in
streamlining further tests in the diagnosis of major diseases. 相似文献
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This paper presents the use of iterative dynamic programming employing exact penalty functions for minimum energy control problems. We show that exact continuously non-differentiable penalty functions are superior to continuously differentiable penalty functions in terms of satisfying final state constraints. We also demonstrate that the choice of an appropriate penalty function factor depends on the relative size of the time delay with respect to the final time and on the expected value of the energy consumption. A quadratic approximation (QA) of the delayed variables is much better than a linear approximation (LA) of the same for relatively large time delays. The QA improves the rate of convergence and avoids the formation of ‘kinks‘. A more general way of selecting appropriate penalty function factors is given and the results obtained using four illustrative examples of varying complexity corroborate the efficacy of the method. 相似文献
8.
James K. Hartsfield Bryan D. Hall Arthur W. Grix Boris G. Kousseff Jose F. Salazar Scott M. W. Haufe 《American journal of medical genetics. Part A》1993,45(5):552-557
We report on 7 patients (6 M, 1 F) with Coffin-Lowry syndrome who have a sensorineural hearing deficit in addition to developmental delay and characteristic facial changes. One of the patients also had a history of premature exfoliation of primary teeth. These are previously unappreciated clinical signs that may aid in the early diagnosis of Coffin-Lowry syndrome. Early diagnosis and recognition of a hearing deficit in the patient can lead to the use of hearing aids to help the patient achieve his or her full potential. These “;new”; clinical manifestations expand the phenotype of Coffin-Lowry syndrome and constitute an additional indication of pleiotropy. © 1993 Wiley-Liss, Inc. 相似文献
9.
H. Bonél A. Frick H. Sittek A. Heuck M. Steinborn R. G. H. Baumeister M. Reiser 《Der Radiologe》1997,37(10):785-793
Summary
Purpose of this study was to evaluate the diagnostic value of a low field dedicated MRI system in hand and wrist imaging.
All 308 exams of the hand and wrist, that were performed on a low-field dedicated MRI system (Artoscan, Esaote Biomedica,
Italy) in our institution in 1996, and high-field MRI exams performed in addition as part of the diagnostic work-up, were
evaluated and correlated to final operative (n = 64) and histologic (n = 12) reports. 90 % of all low-field MRI scans stated a diagnosis according to clinical suspicion. In 62 % the clinical question
was answered, and in 26 % additional pathologies were identified. An MR-diagnosis completely different from the clinical suspicion
was stated in 2 %. High field exams contributed additional information in 6 of 36 patients. In 3 patients a tumor was not
shown completely in the limited field-of-view of the dedicated low-field MRI-system. Frequency-selective fat-suppression pulse
sequences and a better spatial resolution were the reasons for the additional information obtained in the other three patients.
Low-field dedicated MR-imaging is a valuable method in the extensive work-up of the hand and wrist. Osseous, ligamentous and
tendinous pathologies are well depicted. Large or infiltrative tumors should be referred to a high-field system.
相似文献
10.
腰椎间盘突出是骨科常见病。CT扫描能够显示间盘组织的直接影像,是诊断间盘病变的重要方法。本文对80例腰间盘突出进行分析,探讨CT对腰间盘突出的诊断价值。1 材料和方法 1.1一般资料 选用临床及CT表现均典型病例80例,男13例,女37例,年龄17岁-74岁,病程最短2d,最长22a, 相似文献