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Interscalene cervical plexus block: a single-injection technic.   总被引:7,自引:0,他引:7  
A review of the anatomy of the cervical plexus and surrounding structures suggests a single-injection technic which simplifies anesthesia of the cervical plexus and increases the margin of safety in this procedure. Used by the authors, the technic has been successful in 97 percent of over 100 cases.  相似文献   
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Interscalene brachial plexus block   总被引:7,自引:0,他引:7  
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In most Western countries, screening mammography and breast-conserving therapy (BCT) are now well-established practices and have been well accepted by women over the last two decades. There are limited data on the acceptability of these strategies by Chinese women in an Oriental society where a population-based screening program has not been established and mastectomy is still commonly practiced. A survey was conducted of 1012 Hong Kong Chinese women, ages 18-69 years, to assess the level of knowledge, perceptions, and attitudes on screening mammography and the surgical management of early breast cancer. Most women (58%) had never heard of mammographic screening, and housewives were more likely to have heard of it than nonhousewives (49% versus 37%; p = 0.0001). The majority (82%) of those who had heard of mammographic screening believe that it can detect early breast cancers and reduce mortality, however, only 58% of these women would participate in yearly screening and clinical breast examination despite acknowledging the potential benefits; a lack of time and the cost were the predominant reasons given. Forty-seven percent of women had the misconception that mastectomy was the only curative treatment; when the alternative was explained, the overall rate for choosing BCT rose from 29% to 49%. There was no correlation between age and the choice of surgery. Most women (75%) felt that breast reconstruction after mastectomy was desirable and acceptable. A lack of knowledge on mammographic screening is prevalent and the concept of preventive health care has a low priority in this Chinese population. Mastectomy is still widely perceived as the only curative treatment; BCT with cosmetic reconstruction is seen as an acceptable alternative. Interventions to improve the accuracy of information and to encourage preventive health care behaviors will have a positive impact on establishing cancer screening programs and providing quality cancer care in the future.  相似文献   
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INTRODUCTION: Annually more than 2 million pilgrims from all over the world attend the Hajj in Saudi Arabia. Overcrowding during this pilgrimage leads to a high risk of transmission of airborne infectious diseases. Tuberculosis (TB) is common among hospitalized pilgrims, but the overall risk of acquiring Mycobacterium tuberculosis infection during this pilgrimage is not known. We conducted a prospective study to assess the risk of M. tuberculosis infection among Hajj pilgrims. METHODS: We measured the immune response to TB antigens using a whole-blood assay (QuantiFERON TB assay) prior to departure and 3 months after return from the Hajj pilgrimage. RESULTS: Of 357 paired assays, 149 pilgrims were negative prior to the Hajj and 15 (10%) of these had a significant rise in immune response to TB antigens. CONCLUSIONS: Pilgrims may be at high risk of acquiring M. tuberculosis infection during the Hajj. This has significant public health implications for TB control in countries with large Muslim populations.  相似文献   
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We report the unusual presentation of a previously healthy girl with sudden cardiopulmonary arrest caused by acute lymphoblastic leukemia and mediastinal involvement leading to acute tracheal and airway obstruction. Despite active resuscitation and mechanical ventilation, she developed severe cerebral edema as a result of cerebral asphyxia. She also had facial edema caused by superior vena cava obstruction, a high peripheral white cell count with blast differentials, and renal failure. Because of severe asphyxia leading to brain death and renal failure, chemotherapy was withheld. Her white cell count spontaneously reverted to reference range without chemotherapy. This report serves to alert clinicians of the oncological emergency of "superior mediastinal syndrome" causing airway and superior vena cava obstruction leading to death in this potentially curable disease.  相似文献   
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