印度某医疗中心机械性眼外伤患者受伤情况分析

目的:研究农村转诊中心到访以病人机械性眼损伤模式.方法:本研究在Dr.Rajendra Prasad Government Medical College(RPGMC),Kangra(Himachal Pradesh)眼科进行.研究从2013-01-01/2013-12-31,周期12mo,包括数据收集、整理、描述、分析和解释,然后进行为期1 mo的随访.前瞻性研究,包括200例机械性眼损伤的患者,所有患者都接受了问卷调查,并进行详细的眼部检查.根据国际眼损伤类型分为开放性眼球损伤和闭合性眼部损伤.受损的眼睑、泪腺以及颅神经麻痹视为独立存在,通过MS Excel 2007表格使用Epi info7软件进行数据分析.结果:在研究期间,共接收门诊患者21710例,其中200例为机械性眼损伤,占门诊总人数的0.921%.患者年龄为1~80(平均33.12±20.48)岁.151(75.5%)例男性,49(24.5%)例女性患者,男女比例为3:1.200例受试者中,眼部损伤情况分别为:家中(100眼)、运动场所(29眼)、职业损伤(29眼)、道路交通事故(38眼)、暴力冲突(10眼)、学校(3眼)、宗教场所踩踏事故(1眼).就诊时视力达到6/12的有47%,<6/12~6/36有13.5%,<6/36~1/60有6%,<1/60~光感有22%,无光感的4%.7.5%患者视力无法通过国际标准视力表评估.大多数患者为闭合性眼部损伤(54.5%),涉及眼睑、泪腺(23%),开放性眼部损伤为19.5%,3%累及颅神经.结论:眼部机械性损伤是造成单眼失明的常见病因,具有可预防性.     

Association of Insurance Status with Patient Health at New Orleans Student-Run Free Clinics

Since the closure of Charity Hospital after Hurricane Katrina, New Orleans Student-Run Free Clinics have helped fill the resulting void in healthcare access for the underserved New Orleans population. To better understand the health insurance status and health outcomes of this patient population, 1036 patient records from seven New Orleans Student-Run Free Clinics were collected and analyzed between February 2017 and March 2020. Insurance status was significantly associated with gender, race, homelessness, and prior incarceration, but not with education. Substance use rehabilitation centers had low uninsured rates, while homeless shelters had higher uninsured rates. Patients on Non-Medicaid insurance were most likely to be prescribed a medication for diabetes (p?=?.01), hypertension (p?=?.21), and psychiatric conditions (p?=?.04), followed by those on Medicaid, and then those who were uninsured. This study demonstrates the benefits of health insurance and provides important data that can inform future health insurance enrollment efforts and health policy.

     

Low-dose methotrexate in rheumatoid arthritis: a potential risk factor for bisphosphonate-induced osteonecrosis of the jaw

Bisphosphonate-induced osteonecrosis of the jaw [BIONJ] is a relatively new pathological condition which was first described in the year 2003. The prevalence of BIONJ in patients on oral formulations is around 0.05% within the first 3 years and increases up to 0.2% after 4 years of consumption. Proven systemic risk factors like anemia, uncontrolled diabetes, corticosteroid therapy, and chemotherapy in neoplastic diseases [e.g., high doses of methotrexate up to 30 mg daily] significantly increase the chances of acquiring BIONJ. We present three patients with osteoporosis and rheumatoid arthritis [RA] who consumed oral bisphosphonates [alendronate] for less than 1 year and developed BIONJ within 2 to 5 months of undergoing a traumatic dental procedure. The patients also gave a history of consuming low doses of methotrexate [disease-modifying anti-rheumatic drugs] up to 20 mg weekly for 4 to 10 years. No history of steroid consumption was given by any of the patients. This case series highlights the possibility of rheumatoid arthritis and low-dose methotrexate being potential risk factors for BIONJ. This may be on account of the synergistic effect of methotrexate and bisphosphonates and the pro-inflammatory state created by RA which increased the risk of acquiring BIONJ.