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M Ihász 《Orvosi hetilap》1974,115(43):2535-2538
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Z Kéri  Z Keri  I Fábián 《Orvosi hetilap》1979,120(49):2979-2982
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有关杨晓霞“怪病”病原菌的血清学调查   总被引:3,自引:0,他引:3       下载免费PDF全文
山东小姑娘杨晓霞所患“怪病”,根据细菌学、血清学、药敏试验等研究结果,诊断为多细菌协同性坏疽。为了进一步探讨该病的最初病原菌及其来源.作者从患者家乡采集血清18人份,以从患者标本中分离的4种细菌的全菌蛋白为抗原,用Westernblot方法进行了调查。结果显示:Y6和YP菌株可能和患者生活环境有关,Y6菌株有可能来源于池塘水中,作为最初病原菌的可能性最大;Y6和YP菌株目前尚不能鉴定,对动物有毒力,有可能为新的病原菌。迟缓优杆菌、低酸链球菌和环境无关。  相似文献   

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Swallowing problems are common in hospital inpatients and may affect morbidity and mortality. Accurate assessment of dysphagia is important, allowing optimal management and minimizing potential complications. This article considers the methods of swallow assessment available and ways in which problems can be addressed.  相似文献   

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PURPOSE OF REVIEW: This review examines recent studies of the evaluation and treatment of oropharyngeal dysphagia as well as papers investigating oropharyngeal dysphagia and nutritional management. RECENT FINDINGS: There continue to be difficulties in accurate diagnosis of some disorders in oropharyngeal swallow, accounting for the patient's dysphagic symptoms and in identifying optimal treatment strategies for each patient. The efficacy of new techniques for the treatment of oropharyngeal dysphagia have been examined in various populations. Exercise programs have been showing increased efficacy in particular patient groups. SUMMARY: Articles in this past year have focused largely on identifying new procedures for assessment of oropharyngeal swallowing and defining treatment effects. Relatively little work has examined nutritional management in patients with oropharyngeal dysphagia. Most studies that have investigated nutritional management do not carefully define the patient's medical diagnosis or specific swallowing disorders. Similarly, those that study oropharyngeal dysphagia do not relate these data to nutritional management of these patients.  相似文献   

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OBJECTIVES: To assess geriatric patients' assessment of their clinical symptoms of dysphagia by means of a customized dysphagia screening tool and the usefulness of this assessment to health care professionals. DESIGN: The screening tool was distributed to an appropriate cohort and the entries correlated with results of standard speech-language pathology clinical assessments. SETTING: A large long-term care/subacute rehabilitation facility. PARTICIPANTS: There were 199 new admissions screened. The patients included 74 (37.2%) males and 125 (60.8%) females. Patients' ages ranged from 50 to 98 with the mean age of 79.9 years. MEASUREMENTS: The screening tool used requires yes/no patient responses to 9 clinical indicators of dysphagia: difficulty keeping liquids in the mouth; coughing after drinking; shortness of breath while drinking; voice change after drinking; coughing after eating; shortness of breath after eating; food getting stuck in the mouth/throat when eating; voice change after eating; difficulty with saliva. After completing the questionnaire, the speech-language pathologist then conducted a standard bedside swallowing examination using the same 9 indicators. RESULTS: The findings suggest that although patients are less discriminating than clinicians in recognizing swallowing problems, the screening tool as a generalized indicator of potential for dysphagia is consistent and reliable. Individual items should not be used as indicators of dysphagia, but as a whole, the screening tool completed by patients is a reliable indicator of potential for dysphagia. CONCLUSION: Patients' awareness of their own swallowing impairment represents an important aspect of functional recovery. The findings of the study indicate that when patients self-identify a swallowing problem, the speech-language pathologist also identifies the existence of a problem, although not the same problem identified by the patient, with the same intensity or with the same manifestation.  相似文献   

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Self-expanding stents for malignant dysphagia.   总被引:2,自引:0,他引:2       下载免费PDF全文
Self-expanding metallic stents have been employed successfully for vascular, urethral, and biliary strictures. In a prospective study we examined the efficacy of the 16 mm Wallstent for palliation of malignant dysphagia. Eight patients with severe dysphagia due to advanced primary (four) or secondary (four) oesophageal malignant disease were recruited and nine Wallstents were inserted (one patient required two). Dysphagia was reduced in all but one patient, who died after oesophageal perforation; a second patient had a self-limiting bout of haematemesis. Two patients required subsequent treatment for tumour ingrowth but five had no further palliative therapy from stent insertion to time of death. With careful patient selection and skillful application, a 16 mm self-expanding metal endoprosthesis affords effective palliation in malignant oesophageal obstruction.  相似文献   

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近期,关于周星驰新宠张雨绮被曝未成名前,曾做过近20处抽脂减肥的相关新闻频频见诸报端。一时间,关于“星女郎”吸脂减肥的事情成为娱乐八卦的又一热炒话题。在娱乐之余,人们不禁疑惑:吸脂减肥到底好不好?会不会有损健康?现在都流行哪些吸脂减肥技术呢?  相似文献   

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OBJECTIVE: To examine the ability of registered dietitians to identify patients at risk for dysphagia and make appropriate diet/feeding recommendations in comparison with the speech-language pathologist, and to determine screening criteria for the registered dietitian to use for prediction of dysphagia risk. DESIGN: The dietitian and speech-language pathologist performed dysphagia screening on subjects independently through questioning and/or mealtime observation to identify signs and symptoms of dysphagia. Presence of dysphagia risk and diet/feeding recommendations were determined and results from the dietitian and speech-language pathologist were compared. SUBJECTS/SETTING: Thirty-four patients admitted during a 2-month period to a neuroscience unit at an urban teaching hospital were analyzed prospectively. STATISTICAL ANALYSES PERFORMED: kappa Statistics were used to assess agreement between the dietitian and speech-language pathologist. A kappa level of less than 0.4 indicated weak agreement, 0.4 to 0.7 indicated moderate agreement, and greater than 0.7 indicated strong agreement. Logistic regression methods were used to evaluate screening criteria as potential predictors of dysphagia risk. RESULTS: Moderate agreement (0.61) was found between the dietitian and speech-language pathologist in determination of dysphagia risk. The dietitian predicted the ability of the patient to consume an oral diet with strong agreement with the speech-language pathologist (1.0); various diet consistencies with moderate agreement (0.61); and the need for liquid restrictions with strong agreement (1.0). The most significant screening variables for prediction of dysphagia risk (P < .05) were age (P = .018), history of dysphagia (P = .042), difficulty swallowing solids (P = .0007), observed facial weakness (P < .0001), and a change in voice quality (P = .0007). Self-reported screening variables significantly related to dysphagia risk included drooling of liquids (P = .0009) and solids (P = .0080), facial weakness (P = .0006), change in voice quality (P = .0010), and prolonged eating time (P = .0157). APPLICATIONS/CONCLUSIONS: Dietitians can effectively identify patients with dysphagia. Screening for dysphagia can be implemented as part of standard nutrition assessments and may aid in decreasing dysphagia-related complications.  相似文献   

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A multistage dysphagia diet was developed by the nutrition and the speech-language pathology sections of an inpatient rehabilitation unit to meet a growing need for a diet that would allow dysphagic patients to eat safely and to progress to a wider variety of foods as their swallowing function improved. The diet was constructed empirically by evaluating all foods on the hospital menu for ease of swallowing. It consisted of five solid-food stages and two liquid stages; thickened liquids were provided for patients unable to manage regular liquids. Menus that offered patients choices among food items were designed for most stages. During planning and implementation of the diet, special attention was given to food production concerns, education of staff and other caregivers, and development of instructional materials for patients leaving the hospital. The diet met its goals of providing dysphagic patients with a maximum number of foods that could be swallowed safely, maintaining or improving nutritional status, avoiding unnecessary tube feeding, and winning the support of patients and caregivers.  相似文献   

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