Pharmacy customers’ views and experiences of using pharmacies which provide needle exchange services in Aberdeen and Glasgow, Scotland

Community pharmacists contribution to the management of drug problems is considerable. As the use of illicit drugs has increased, pharmacists have come under increasing pressure to offer services to problem drug users. However, there is concern among some pharmacists that offering such services may deter other customers. There is particular concern among some pharmacists about needle exchange services. Only 9.5% of Scottish pharmacies offer needle exchange services compared to 69% which are dispensing methadone (57% of which supervise methadone consumption). Qualitative interviews were used in a purposive sample of 10 pharmacies in Scotland. Eight customers were interviewed in each pharmacy to ascertain pharmacy customers’ views on these services. The majority of customers were supportive of these services. Customers were often unaware that the pharmacy they were interviewed in was offering services for people with drug problems. Pharmacy customers were more knowledgeable about, and more supportive, of needle exchange services than they were of methadone. This was because they believed needle exchange services helped to reduce the amount of discarded needles in public places. Pharmacy customers also recognised that needle exchange helped reduce the spread of disease. These findings should be used to encourage more pharmacists to offer needle exchange services.     

胸腰椎病变CT监视下穿刺活检路径分析

目的探讨胸腰椎病变CT监视下穿刺活检中穿刺路径的选择方法。方法141例胸腰椎病变临床诊断不清患者，其中胸椎70例，腰椎71例。根据病变位于脊椎的不同部位选择合适的穿刺路径，于CT监视下穿刺取材。穿刺路径：经椎旁路径63例，经椎弓根路径45例，经肋椎关节路径11例，其他路径22例。结果141例中共有128例诊断正确，穿刺结果诊断正确率为90．8％。无并发症发生。结论胸腰椎病变穿刺路径的选择要根据病变的位置不同具体分析。总的原则是安全、取材量多、对患者损伤小。     

应用综合评估法术前评估骨巨细胞瘤的侵袭性

应用穿刺活检进行病理诊断和分级,同时作DNA含量图象法分析,结合X线平片表现对骨巨细胞瘤的侵袭性进行综合评价,结果显示,在综合分级中,Ⅰ与Ⅱ级的复发率有显著性差异,而病理和X线分级则无显著性差异。提示综合分级对评估骨巨细胞瘤的侵袭性具有合理性和全面性,有助于指导治疗。     

护理人员工作中被针刺伤调查及对策

目的：了解护理人员被针刺伤的情况，为采取职业防护措施提供科学依据。方法：采用问卷调查法调查护理人员被针头伤的有关情况。结果：不同职称护理人员被针刺伤的情况存在差异高度显著性，P＜0．01；不同科室护理人员被针刺伤的操作环节比较均存在差异高度显著性，P＜0．01，绝大多数护理人员对针刺伤后的处理不规范。结论：护理人员应主动增强职业防护意识，加强职业防护管理；改进废弃的一次性医疗用品管理方法和尽快采用防刺性护理用具。     

Needle tract recurrences after closed biopsy for sarcoma: Three cases and review of the literature

Background: Percutaneous closed needle biopsy of musculoskeletal neoplasms has gained in popularity. However, it remains controversial whether or not to resect the needle tract for fear of a local recurrence. A single published case report exists, noting the lone tract recurrence of an extremity skeletal osteosarcoma. Methods: We report on three additional individuals who demonstrated that tract local recurrences may occur after a closed needle biopsy for nonosteosarcoma, nonextremity sarcomas. For perspective, the world literature is reviewed to identify tract recurrences for other malignancies and the results of needle biopsy in musculoskeletal neoplasms. Results: Eighty-nine percent of needle tract local recurrences occur when carcinomas are subjected to biopsy, as reported in the literature. Forty-seven cases since 1950 are described representing essentially all tumor types. The nature of musculoskeletal neoplasms makes closed biopsy more difficult than for softer, more homogeneous, and easier to access neoplasms. Conclusions: Local recurrences of sarcoma may occur in closed needle biopsy tracts. Strong consideration should be given to open biopsy and tract resection.     

Belt device for simplified CT-guided puncture and biopsy: A technical note

A new radiolucent device for increased accuracy of CT-guided fine-needle punctures permits precise determination of the optimum angle, depth, and position of the fine needle, which can be preset from the data supplied on the CT monitor. Puncture and repeat scans for controlling the tip of the needle can be performed with the patient in a stationary position. The device is designed as a belt that holds a needle holder sheath and a goniometric scale, both of which can be moved to varying positions around the patient.     

针刺导管空肠造口术肠内营养在胰十二指肠切除术病人中的应用

目的探讨针刺导管空肠造口术(NCJ)肠内营养(EN)在胰十二指肠切除术病人中的应用效果。方法32例病人,16例术后肠外营养(PN)(对照组),16例术后行导管空肠造口术(NCJ)肠内营养(EN)治疗(实验组)。结果术后实验组的胃肠动力比对照组的恢复早(P<0.05)。治疗前两组病人血蛋白指标(白蛋白、前白蛋白、转铁蛋白)无明显差异。治疗后两组均升高,而实验组血蛋白指标的水平明显高于对照组(P<0.05),二者差异显著。结论导管空肠造口术(NCJ)肠内营养(EN)应用于胰十二指肠切除术病人中比肠外营养(PN)具有更多的优点。     

Raz four-corner suspension for severe cystocele: Poor results

The Raz four-corner suspension for the treatment of severe (grades 3 and 4) cystocele has yielded poor results, and is the subject of this paper. During a 10-month period from June 1988 to April 1989, 27 patients with severe cystocele and genuine stress incontinence were treated by the Raz four-corner suspension. Each patient had full preoperative urodynamic evaluation. Twenty-two patients were available for follow-up examinations at 3.5–4 years. At the 6-week postoperative examination all patients had excellent support of the anterior vaginal wall, including the restoration of the anterolateral vaginal wall sulci. However, within 10 months, 6 patients had recurrence of cystoceles of grade 2 or more. These results led to the abandonment of this procedure. On long-term follow-up examination at 3.5–4 years, 59% (13/22) of the patients had recurrence of cystoceles of grade 2 or more. The possible causes for these poor results are discussed. At present therefore, the Raz four-corner suspension for severe cystoceles is not recommended.     

CT导引下胸部病变穿刺活检不同方法的临床探讨

目的探讨胸部病变穿刺活检联合同轴针吸对提高阳性率减少并发症的价值。方法回顾性分析CT导引下106例胸部病变三种不同穿刺方法的阳性率及并发症。结果单纯针吸组32例,检出恶性病变23例,良性4例,阳性率为84.3%,并发症为15.6%;单纯活检组27例,检出恶性病变15例,良性7例,阳性率为81.5%,并发症为48.1%;活检同轴针吸组47例,检出恶性病变28例,良性15例,阳性率91.5%,并发症为29.7%。结论活检联合同轴针吸是提高阳性率减少并发症的较好的活检方法,它既弥补了活检的缺点,又集中了针吸的优点,是值得推广的活检方法。