Migraine: A Symptomatic Case History

Data from 28 years of the author's personal migraine diary are analyzed for patterns of aura and headache. A total of 186 occurrences of migraine are analyzed. A migraine-interval histogram suggests that, although the median interval between attacks is 37 days, there is an underlying cyclical interval of just 6 to 10 days. Distinct patterns are found for specific combinations of aura and symptoms depending on whether both sides, the right side, or the left side of the head were involved in the attack.     

Case History: Scrofuloderma

Until recently, Canada enjoyed relative freedom from tuberculosis compared with other countries, but since the late 1960s this disease has been on the increase.     

Urostomy products: an update of recent developments

This article provides an overview of the recent developments in appliances for people with a urostomy. Following a short background, the products that may be useful for this patient group are discussed.     

Case History: Adhesive Vulvitis in Childhood

In a case of adhesive vulvitis or agglutination of the labia in a young female, treatment with local applications of estrogen cream to the area resulted in complete separation of the labia within a period of one month.     

尿路造口患者自护能力现状及其影响因素分析

目的 调查尿路造口患者出院后自护能力的现状并分析其影响因素,旨在为该类患者自护能力的干预性研究提供依据.方法 于2019年6—9月选取门诊就诊的尿路造口患者为调查对象,采用一般资料调查表、造口自我护理量表-早期版(SSCS-ESV)、中文版造口接受度问卷、自尊量表、社会影响量表(SIS)进行调查.结果 共收回有效问卷1...     

Continent intestinal reservoir

In this series, 170 patients have received a continent intestinal reservoir, with follow-up of one to eight years. In 126 a conventional ileostomy was converted to a continent intestinal reservoir, 38 at the time of coloproctectomy. Six had an unsatisfactory ileoanal or ileorectal anastomosis initially, and 26 (15%) required revisional surgery for problems involving the reservoir or valve. The incidence of valve slippage was 3%. Eighty-five percent achieved a normally functioning small bowel reservoir with one operation, and 19 more patients were added with one additional operation, for an ultimate good result of 96% with two operations at most. The average reservoir capacity is 400 ml, and most patients empty the pouch two or three times per day. Under favorable circumstances, the continent intestinal reservoir is preferable for most patients after coloproctectomy.     

Urostomy appliances and stoma care routines. The relation to peristomal skin complications

The aim of the study was to describe types of appliances and stoma care routines and evaluate their relation to peristomal skin complications. Sixty-six patients with a cutaneous uretero-ileostomy were interviewed and the peristomal skin was assessed according to Classification of Peristomal Skin (CPS). The results show a conservatism regarding the types of appliance and the stoma care routines. More than half of the patients used the same product at follow-up as they were initially fitted with three to 14 years earlier. The routines adopted by the patients were often inadequate, resulting in skin complications. Continuous exposure of the skin to urine by creation of a too wide opening in the face-plate and infrequent changing of the appliance resulted in development of pseudoverrucose skin lesions.     

一件式泌尿造口袋应用于引流管大量渗漏的临床效果

目的探讨引流管大量渗漏时使用一件式泌尿造口袋的临床效果。方法采用便利抽样法选择南方医科大学珠江医院2011年3月至2013年7月行外科手术治疗后发生引流管渗漏的患者102例,采用随机数字表法分成A、B、C三组,每组各34例,A组采用常规换药后覆盖无菌纱布再盖医用无菌棉垫;B组采用剪短引流管保留5~10cm,将引流管末端放置在一件式泌尿造口袋中,造口袋粘贴在引流管口收集引流液和渗漏液;C组采用一件式泌尿造口袋粘贴在引流管口收集渗液,造口袋上剪一开口,引流管末端从造口袋开口穿出后接一次性抗反流尿袋。比较三组患者的舒适度、满意度和周围皮肤刺激性皮炎的发生率以及换药时间、次数和费用。结果 B、C组患者在疼痛/不适及焦虑/沮丧等方面的舒适度及满意度高于A组,刺激性皮炎的发生率低于A组,换药时间、换药次数及换药费用低于A组;B组换药时间及换药费用又低于C组,差异均有统计学意义(均P0.05)。结论应用一件式泌尿造口袋处理引流管大量渗漏能提高患者的舒适度和满意度,减少不良反应和换药次数等;且采用将剪短的引流管末端放置在一件式泌尿造口袋中的方法更能节省换药费用和换药时间,减轻医生和护士的工作量。     

一件式和两件式泌尿造口袋在胰周脓肿引流管护理中的应用体会

目的探讨微创治疗重症急性胰腺炎继发胰周脓肿后引流管护理的方法,比较一件式和两件式泌尿造口袋的应用时机和方法。方法在微创治疗重症胰腺炎患者的过程中,根据引流流管口粗细和沿引流管流出的脓肿引流液的量,在合适的时机选用一件式或两件式泌尿造口袋护理引流管。结果本组48例患者均采用一件式或两件式泌尿造口袋引流,引流液观察记录准确,无一例发生引流管周围皮肤浸渍,且减少医护工作量,为患者节约费用。结论声镜结合的方法治疗重症急性胰腺炎继发胰周脓肿的护理关键在于引流管护理,合理使用一件式或两件式泌尿造口袋护理引流管能收到事半功倍的效果,值得在临床上推广应用。     

Is This the Natural History of the Retention Wire? A Case Report

We report on a 71-year-old man who had a dual chamber pacemaker implanted in 1991. A Class IV fracture of the Telectronics Accufix 330–801 atrial lead was observed on a chest X ray in December 1993. Serial chest X ray and fluoroscopy documented stable position of the migrated fractured f wire. The patient remained asymptomatic and a decision for conservative monitoring was made. A subsequent finding of a right atrial mass on echocardiography and evidence of pulmonary embolism on lung scan prompted a change of strategy. The patient underwent atriotomy, and a right atrial thrombus was discovered associated with the fractured J retention wire, both of which were extracted uneventfully. This case is illustrative that despite apparent stability of a Class IV fracture, it may result in endothelial injury with a thrombogenic nidus and resultant complications.     

A Curious Case of Rash: A Clinical Case Challenge

This case presents a middle-aged woman who had chronic rash. Rashes are a common problem in primary care and are often accompanied by a variety of diagnostic challenges. This case guides practitioners through the patient presentation, differential diagnoses, and diagnostic workup for definitive diagnosis. Therapeutic interventions, follow-up, and patient education topics are discussed in relation to the diagnosis.