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911.
Daniel Klase Stefan Gottschalk Erich Reusche Christian Hagel Einar Goebel Volker Tronnier Alf Giese 《Child's nervous system》2007,23(8):907-912
CASE REPORT: The reported female patient underwent sub-total resection of an intra-medullary cervicothoracic astrocytoma classified as WHO grade II in 1984 at the age of 18 months and received local irradiation. In 1989, a local recurrence was diagnosed and a partial resection was performed. Sixteen years later, a small recurrent cervicothoracic tumour was found and spinal seeding to the equine nerve roots and the left cerebellar cortex was apparent on MRI. The patient was implanted with a ventriculoperitoneal shunt for a pseudo-tumour cerebri producing papilloedema, which eventually lead to amaurosis. After an extended biopsy, the invasive lumbosacral tumour was classified as glioblastoma multiforme. Two months later, the patient died after rapid progression of the caudal cranial nerve dysfunction. DISCUSSION AND CONCLUSION: Anaplastic progression and dissemination of spinal astrocytomas even two decades after initial diagnosis and treatment are rare. Therapies and diagnostic follow-up strategies are discussed. 相似文献
912.
913.
914.
Tim Söderlund Ilkka Tulikoura Mika Niemelä Lauri Handolin 《European journal of trauma and emergency surgery》2009,35(5):455-462
Objective:
The aim of the present study was to characterise traumatic deaths occurring in the emergency room (ER) and to assess retrospectively the quality of given emergency care by evaluating whether any of the deaths could be identified as potentially preventable. 相似文献915.
Susan Miesfeldt Christine Hayden Netta Apedoe Sharon Jerome Andrea Fletcher 《Journal of community health》2010,35(2):109-114
Over 800 Maine residents will be diagnosed with colorectal cancer (CRC) this year, and nearly 300 will die from the disease.
While CRC screening can reduce these rates, it is only among insured populations that screening rates exceed 50%. This project
aimed to reduce barriers to, and increase rates of CRC screening among underinsured and uninsured women, ages 50 years and
over, residing in Cumberland County, Maine. The existing network of the Maine Breast and Cervical Health Program (MBCHP) was
used to reach the target population. A packet containing (1) an offer for no-cost fecal occult blood test (FOBT) screening
and CRC-related educational materials, and (2) a stamped, addressed postcard specifying the woman’s interest in these resources,
was mailed to 300 MBCHP enrollees residing in Cumberland County. Women requesting screening were contacted by phone to further
determine eligibility. Ninety-three women (31%) requested FOBT kits and 29 of these women requested educational materials.
Ten women were ineligible for screening because of previous colonoscopy. Fifty-two completed FOBT kits (63%) were returned;
all were negative. An additional 42 (14%) women requested educational materials only. To reduce the burden of CRC in Maine
and nationally, disparate populations must be reached with efficient and effective screening services. Established networks
are proven means for reaching uninsured and underinsured individuals with education, screening services, and necessary follow-up
care. This project serves as a model for the future development of similar programs statewide and nationally. 相似文献
916.
Shirley A. Musich Alyssa B. Schultz Wayne N. Burton Dee W. Edington 《Disease Management & Health Outcomes》2004,12(5):299-326
Corporations have engaged in sponsorship of health management programs and, more recently, disease management programs to facilitate healthy and productive work environments. The purpose of this review is to examine the health and financial outcomes from these corporate-sponsored disease management programs. This article focuses on seven diseases or chronic conditions (arthritis, asthma, cancer, depression, diabetes mellitus, heart disease, and migraine) that potentially impact employee productivity (both in time away from work and in loss of effectiveness at work) and health status including medical and pharmaceutical utilization and costs.Corporate-sponsored disease management programs typically focus on education and screening for selected diseases or chronic conditions. Partnerships have been formed with health plans and third-party program providers to reach employees with interventions and treatment. The typical outcome measures from these programs have primarily been clinical indicators and medical utilization. Measures of productivity need to be incorporated as important outcome measures for disease management programs.The estimated financial opportunity for the corporation is a reflection of the cost differential for a given disease and the prevalence of that disease within the employee population. Primary diseases, chronic conditions, and health risks contribute to increased medical utilization and decreased productivity within the corporation. Promoting programs that focus on the whole person, including health risks, chronic conditions, and diseases, will likely increase the possibility of success in helping the employee to better self-manage their health conditions and consequently provide gains for both the individual and the corporation. 相似文献
917.
918.
Objective
To observe and evaluate the value of utilizing selective internal iliac artery infusion and selective internal iliac artery embolization for the treatment of unremitting gross hematuria of stage T4 bladder carcinoma. 相似文献919.
Burcin Ozer Muserref Tatman-Otkun Dilek Memis Metin Otkun 《Central European Journal of Medicine》2010,5(2):203-208
The aim of this study was to determine the types nosocomial infections (NIs) and the risk factors for NIs in the central intensive
care unit (ICU) of Trakya University Hospital. The patients admitted to the ICU were observed prospectively by the unit-directed
active surveillance method based on patient and the laboratory over a 9-month-period. The samples of urine, blood, sputum
or tracheal aspirate were taken from the patients on the first and the third days of their hospitalization in ICU; the patients
were cultured routinely. Other samples were taken and cultured if there was suspicion of an infection. Infections were considered
as ICU-associated if they developed after 48 hours of hospitalization in the unit and 5 days after discharge from the unit
if the patients had been sent to a different ward in the hospital. The rate of NIs in 135 patients assigned was found to be
68%. The most common infection sites were lower respiratory tract, urinary tract, bloodstream, catheter site and surgical
wound. Hospitalization in ICU for more than 6 days and colonization was found to be the main risk factor for NIs. Prolonged
mechanical ventilation and tracheostomy, as well as frequently changed nasogastric catheterization, were found to be risk
factors for lower respiratory tract infections. For bloodstream infections, both prolonged insertion of and frequent change
of arterial catheters, and for urinary tract infections, female gender, period and repeating of urinary catheterization were
risk factors. A high prevalence rate of nosocomial infections was found in this study. Invasive device use and duration of
use continue to greatly influence the development of nosocomial infection in ICU. Important factors to prevent nosocomial
infections are to avoid long hospitalization and unnecessary device application. Control and prevention strategies based on
continuing education of healthcare workers will decrease the nosocomial infections in the intensive care unit. 相似文献
920.