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排序方式: 共有2714条查询结果,搜索用时 15 毫秒
1.
Ángel Becerra Héctor Trujillo Lucía Valencia Aurelio Rodríguez‐Pérez 《Brazilian Journal of Anesthesiology》2019,69(2):200-203
Background and objectives
A prompt and effective management of trauma patient is necessary. The aim of this case report is to highlight the importance of intraoperative echocardiography as a useful tool in patients suffering from refractory hemodynamic instability no otherwise explained.Case report
A 41 year‐old woman suffered a car accident. At the emergency department, no abnormalities were found in ECG or chest X‐ray. Abdominal ultrasound revealed the presence of abdominal free liquid and the patient was submitted to urgent exploratory laparotomy. Nevertheless, she persisted suffering arterial hypotension and metabolic acidosis. Looking for the reason of her hemodynamic instability, intraoperative transthoracic echocardiography was performed, finding out the presence of pericardial effusion. Once the cardiac surgeon extracted pericardial clots, patient's situation improved clinically and analytically.Conclusion
Every anesthesiologist should be able to use the intraoperative echocardiography as an effective tool in order to establish the appropriate measures to promote the survival of patients suffering severe trauma. 相似文献2.
3.
Nathan L. Haas Adam Nicholson Mary R.C. Haas 《The American journal of emergency medicine》2019,37(10):1990.e3-1990.e5
Delusional parasitosis manifests as a fixed, false belief that an individual is infested by living organisms. Primary delusional parasitosis is a psychiatric disorder with the delusion as an isolated manifestation, whereas secondary delusional parasitosis is a delusion occurring secondary to a psychiatric disorder, substance use, or medical illness. A 62-year-old woman with no psychiatric history presented to the Emergency Department with two to three months of “whole body itching” and seeing small insects crawling on her skin and in her hair. Exam of her skin and scalp was notable for no appreciable lesions, rashes, excoriations, or insects. Her neurologic exam was notable for full visual fields, and no localizing deficits. A non-contrast head CT demonstrated a nonspecific heterogeneous low-attenuation lesion within the medial right occipital lobe, and a follow up MRI confirmed a right posterior cerebral artery distribution subacute infarction. She was admitted for two days, and ultimately was discharged on aspirin and atorvastatin for secondary prevention. An emergency physician should remain vigilant in his/her assessment of patients with seemingly psychiatric symptoms, in particular elderly patients with no known psychiatric illnesses. Neuroimaging should be amongst studies considered in the evaluation of elderly patients presenting with new onset psychiatric complaints. 相似文献
4.
在我国司法实践中,对医疗意外的损害赔偿主要通过公平责任原则来处理,但是,这种责任分配模式对医患双方都有很大的局限性,不利于医疗纠纷的处理。尽快建立医疗意外保险制度,切实维护医患双方的合法权益,是解决此类纠纷的一个出口。该文从医疗意外保险的必要性出发,探讨应怎样设立医疗意外保险,保险的具体运作模式、保险赔付以及保险赔偿责任的范围等。 相似文献
5.
Timothy P. HUTCHINSON 《Industrial health》2015,53(2):176-177
Maximum acceleration and the Head Injury Criterion (HIC) are both used as indicators of
likely head injury severity. A dataset has previously been published of impacts of an
instrumented missile on four ground surfaces having a layer of between 0 and 16 cm of
sand. The dataset is compared with recently-developed theory that predicts power-function
dependence of maximum acceleration and HIC on drop height. That prediction was supported
by the data. The surfaces differed in respect of the exponents estimated. 相似文献
6.
Naotaka KIKKAWA Kazuya ITOH Tomohito HORI Yasuo TOYOSAWA Rolando P. ORENSE 《Industrial health》2015,53(6):517-521
At present, almost all mountain tunnels in Japan are excavated and constructed utilizing
the New Austrian Tunneling Method (NATM), which was advocated by Prof. Rabcewicz of
Austria in 1964. In Japan, this method has been applied to tunnel construction since
around 1978, after which there has been a subsequent decrease in the number of casualties
during tunnel construction. However, there is still a relatively high incidence of labour
accidents during tunnel construction when compared to incidence rates in the construction
industry in general. During tunnel construction, rock fall events at the cutting face are
a particularly characteristic of the type of accident that occurs. In this study, we
analysed labour accidents that possess the characteristics of a rock fall event at a work
site. We also introduced accident prevention measures against rock fall events. 相似文献
7.
Kamal Narayan Arya Shanta Pandian Abhishek Sharma Vikas Kumar Varun Kumar Kashyap 《Topics in stroke rehabilitation》2020,27(4):272-289
ABSTRACT
Background
The interlimb coupling, coordination between the limbs, gets hampered in post-stroke hemiparesis. Most of the poststroke motor regimes primarily focus on the more affected limb. 相似文献8.
Priscilla Santos Ferreira Ream Anaclara Ferreira Veiga Tipple Dayane Xavier Barros Adenícia Custódia Silva Souza Milca Severino Pereira 《Archives of environmental & occupational health》2016,71(2):59-65
Although not directly responsible for patient care, hospital housekeepers are still susceptible to accidents with biological material. The objectives of this study were to establish profile and frequency of accidents among hospital housekeepers, describe behaviors pre- and postaccident, and risk factors. This was a cross-sectional study with hospital housekeepers in Goiania, Brazil. Data were obtained from interviews and vaccination records. The observations were as follows: (1) participating workers: 94.3%; (2) incomplete hepatitis B vaccination: 1 in 3; and (3) accident rate: 26.5%, mostly percutaneous with hypodermic needles, and involved blood from an unknown source; roughly half occurred during waste management. Upon review, length of service less than 5 years, completed hepatitis B vaccination, and had been tested for anti-HBs (hepatitis B surface antigen) influenced frequency of accidents. These findings suggest that improper disposal of waste appears to enhance the risk to hospital housekeepers. All hospital workers should receive continued training with regard to waste management. 相似文献
9.
《La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne》2020,41(12):843-845
IntroductionWhole body cryotherapy is a new therapeutic for pain treatment. Cryotherapy is, so far, a controversial technique challenged for its efficacy and its security.Case reportThis is the case of a 61-year-old woman suffering from a haemorrhagic cerebrovascular accident during a whole-body cryotherapy session. The patient was treated for a psoriatic arthritis and was in remission. The aetiological screening was negative.ConclusionWe hypothesize that the whole-body cryotherapy was responsible for this stroke. 相似文献
10.
Improvements in Extracorporeal Membrane Oxygenation for Primary Graft Failure After Heart Transplant
《The Annals of thoracic surgery》2023,115(3):751-757
BackgroundSevere primary graft failure is a life-threatening complication of heart transplantation that may require venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. Surgical practices and management strategies regarding VA-ECMO vary between and within centers.MethodsWe performed a single-center retrospective cohort study on adult patients who received VA-ECMO for primary graft failure between 2013 and 2020. Clinical data were obtained from chart review and national databases. Patients were stratified by transplantation before or after 2017, when our center adopted additional objective criteria for VA-ECMO, adopted partial-flow support, and changed from central cannulation to chimney graft arterial cannulation of brachiocephalic, axillary, or aorta. The primary outcome was survival to device weaning. Secondary outcomes were survival to discharge, survival to 1 year, complications on support, and time to sedation weaning and extubation.ResultsFrom 276 heart transplant recipients, 39 severe primary graft failure patients requiring VA-ECMO were identified. Incidence of graft failure was 13% (n = 18 of 135) pre-2017 and 15% (n = 21 of 141) post-2017. Survival at all time points improved significantly after 2017, with greatest difference in survival to device weaning (61% pre-2017 vs 100% post-2017). After controlling for other factors in multivariable Cox regression modeling, transplantation after 2017 was a predictor of reduced mortality (hazard ratio, 0.209; 95% CI, 0.06-0.71; P = .01). Significant differences were not observed in other secondary outcomes of recovery.ConclusionsThe new VA-ECMO strategy displayed reasonable survival and a remarkable improvement from the prior system. 相似文献