医疗健康无处不在 康德乐形影相随

<正>康德乐公司(纽约证券交易所证券代码:CAH)总部位于美国俄亥俄州都柏林,是一家健康医疗保健服务公司,致力于提高健康医疗的质量与效率、降低成本。从医院到家庭,康德乐通过提供物流服务、商业服务、产品及患者解决方案,支持整个医疗服务价值链。与超过5,000家制药和医疗器械供应商合作在家庭医疗保健方面,服务180万患者,提供40,000种产品支持全美超过20,000家零售药房为超过70%的美国医院提供服务和产品在全球拥有近35,000名员工     

三维超声、宫腔镜联合对<3cm子宫粘膜下肌瘤的诊断应用

目的对比分析三维超声、宫腔镜联合对<3cm子宫粘膜下肌瘤诊断的准确性。方法回顾性分析2004年1月～2007年12月我院经三维超声和宫腔镜诊断的直径<3.0cm粘膜下肌瘤患者85例。结果经三维超声单独诊断为子宫粘膜下肌瘤30例,经宫腔镜单独诊断为粘膜下肌瘤55例,经三维超声和宫腔镜联合诊断为粘膜下肌瘤85例。结论三维超声和宫腔镜无创伤但漏诊率比较高;对直径<3.0cm粘膜下肌瘤患者可运用三维超声和宫腔镜联合诊断作为子宫粘膜下肌瘤筛查手段,这二种手段联合诊断准确直观,是子宫粘膜下肌瘤确诊及治疗的首选方法。     

The clinical and economic impact of a secondary heart disease prevention clinic jointly implemented by a practice nurse and pharmacist

BACKGROUND: A primary care practice in the West of Scotland used clinical governance funding to develop a heart disease prevention clinic to target patients with existing heart disease. The practice nurse enlisted the help of the practice pharmacist and the protocol for the clinic was subsequently developed with the involvement of both practitioners. OBJECTIVE: The aim of this project was to identify and offer health screening and appropriate disease modifying treatment to patients of a primary care (or general medical) practice suffering from cardiovascular heart disease in a clinic run jointly by a practice nurse and pharmacist. METHOD: Patients identified by the practice pharmacist were offered a full health screen. Their clinical parameters were assessed and appropriate disease modifying drug therapy and lifestyle advice was offered in a review clinic with the practice nurse and pharmacist. RESULTS: The practice pharmacist identified over 212 patients over a 30-month period. A majority demonstrated hypertension (91%) and angina (89%), while over half (57%) had suffered a heart attack. Statin therapy was modified in a large number of patients (47%) and the number of patients with satisfactory total cholesterol levels has increased from 30% to 57% (P < 0.001). Aspirin and beta-blocker therapy has been initiated in a significant number of patients (53% and 26% respectively). Twelve patients (6%) stopped smoking; however, many 42% continued to smoke. The general medical doctors (GPs) who demonstrated a change in their own practice readily accepted changes to therapy recommended by the practice nurse and pharmacist. The practice pharmacist offset the additional cost of drug spend on statin therapy by making savings in other therapeutic areas. CONCLUSION: A secondary heart disease clinic can benefit patients by optimising drug and lifestyle therapy. While the inclusion of a pharmacist confers clinical and economic benefits.