Isolated pure dislocations of the fifth carpo-metacarpal joint are extremely rare injuries. The dorsal form was described
in mere 12 cases. The diagnosis can be easily missed. The lesion is also often overlooked in the routine diagnostic X-ray.
Lateral and oblique views are important for the recognition of the true extent of the lesion. Treatment of these injures is
still controversial and both closed reduction with percutaneous pinning or open reduction with internal fixation are advocated.
The goal of treatment is early reduction and fixation of the metacarpal. Early diagnosis is the key to success. The aim of
this paper is to review literature and present two new cases. 相似文献
The aim of this study was to compare the demographic and clinical characteristics of individuals with affective disorders who had attempted suicide at some time in their lives and those who had not made a suicide attempt. In a Chinese rural community, individuals with suicide attempt (N = 30) and those without suicide attempt (N = 166) were assessed with Present State Examination (PSE). Attempters had a significantly higher level of family economic status, higher rate of lifetime depressed mood and hopelessness, and delusions than nonattempters. The logistic regression models also indicated that depressed mood and hopelessness were the most important predictors of suicide attempts. No significant difference in treatment condition was found between attempters and non-attempters. Early identification and interventions focusing on reducing depressed mood, hopelessness, and controlling psychotic symptoms may be helpful in reducing the risk of suicide attempts among individuals with affective disorders residing in the community. 相似文献
Healthcare information systems (HISs) are often implemented to enhance the quality of care and the degree to which it is patient-centered,
as well as to improve the efficiency and safety of services. However, the outcomes of HIS implementations have not met expectations.
We set out to organize the knowledge gained in qualitative studies performed in association with HIS implementations and to
use this knowledge to outline an updated structure for implementation planning. A multi-disciplinary team performed the analyses
in order to cover as many aspects of the primary studies as possible. We found that merely implementing an HIS will not automatically
increase organizational efficiency. Strategic, tactical, and operational actions have to be taken into consideration, including
management involvement, integration in healthcare workflow, establishing compatibility between software and hardware and,
most importantly, user involvement, education and training. The results should be interpreted as a high-order scheme, and
not a predictive theory. 相似文献
Total hip arthroplasty is a successful surgery, that fails at a rate of approximately 10% at ten years from surgery. Causes
for failure are mainly aseptic loosening of one or both components partially due to wear of articular surfaces and partially
to design. The present analysis aimed to identify risk factors and quantify their effects on aseptic failure. 相似文献
Background: Primary afferent nociceptor sensitization and its accompanying spontaneous discharge are believed to be the proximate cause of the spontaneous pain and hypersensitivity that follow an acute tissue injury. Evidence for this comes almost entirely from studies limited to the first few minutes to an hour or two after injury, when the inflammatory reaction to injury has just begun. However, there is evidence that inflammatory pain mechanisms differ from acute pain mechanisms and that the mechanisms that drive and modulate inflammatory pain may evolve over time.
Methods: The authors surveyed spontaneous afferent discharge in rats with hind paw inflammation evoked by complete Freund adjuvant over the entire 14 days of the inflammatory pain condition, as determined in parallel experiments assessing allodynia and hyperalgesia.
Results: Inflammation-evoked heat hyperalgesia, mechanoallodynia, and mechanohyperalgesia began within hours, persisted until at least day 7, and resolved by day 14. A large percentage (23%) of A fibers had spontaneous discharge 2 days after inflammation, but the incidence was much reduced (to 7-9%) by 7 and 14 days. At all times, the A-fiber discharge frequency was low (<3.0 Hz) or very low (<0.3 Hz). A large percentage (24%) of C fibers had spontaneous discharge 2 and 7 days after inflammation, but this also declined to near control levels by day 14; C-fiber discharge frequency was also always low (most at 0.3-1.0 Hz). 相似文献
Skin and soft tissue infections are increasingly prevalent clinical problems, and it is important for health care practitioners
to be well trained in how to treat skin abscesses. A realistic model of abscess incision and drainage will allow trainees
to learn and practice this basic physician procedure. 相似文献