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911.
一所综合医院七年间因自杀急诊者的临床特征分析 总被引:5,自引:0,他引:5
目的 探讨在北京大型综合医院急诊科抢救自杀者的特征及其动态分布。方法 对 1995~ 2 0 0 1年一所综合医院急诊室登记表中诊断为自杀的患者 ,按自编回顾性调查表进行筛查并记录其特征。结果 7年间共有15 34例自杀患者 ,占急诊室就诊人数的 2 94‰ ,未见逐年上升或下降的趋势 ;女性明显多于男性 (男∶女 =1∶2 6 ) ;年龄以青壮年为主 ,平均 ( 33 3± 15 1)岁 ;90 3%的自杀方式是服毒 ( 75 6 %使用治疗性药 ) ;17例 ( 1 1% )自杀死亡 ;春、夏季自杀患者高于秋、冬季 ;多数在晚 6~ 12时急诊 ,80 4 %在院抢救治疗时间少于 1天。结论 自杀已成为综合医院急诊患者中常见的致命问题 ,在急诊工作中应采取相应的治疗及心理干预措施 相似文献
912.
Sardanelli F Giuseppetti GM Panizza P Bazzocchi M Fausto A Simonetti G Lattanzio V Del Maschio A;Italian Trial for Breast MR in Multifocal/Multicentric Cancer 《AJR. American journal of roentgenology》2004,183(4):1149-1157
OBJECTIVE: Our aim was to compare the effectiveness of mammography and MRI in the detection of multifocal, multicentric breast cancer. SUBJECTS AND METHODS: Ninety patients with planned mastectomies (nine bilateral) underwent mammography and dynamic gadolinium-enhanced MRI. Off-site reviewers aware of the entry criterion (planned mastectomy) evaluated both examinations for the presence of malignant foci, recording the density pattern on mammography. The gold standard was pathologic examination of the whole excised breast (slice thickness, 5 mm). RESULTS: Of 99 breasts, pathologic findings revealed 52 unifocal, 29 multifocal, and 18 multicentric cancers for a total of 188 malignant foci (158 invasive and 30 in situ). Overall sensitivity was 66% (124/188) for mammography and 81% (152/188) for MRI (p < 0.001); 72% (113/158) and 89% (140/158) for invasive foci (p < 0.001); and 37% (11/30) and 40% (12/30) for in situ foci (p > 0.05, not significant), respectively. Mammography and MRI missed 64 and 36 malignant foci, respectively, with median diameters of 8 and 5 mm (p = 0.033) and an invasive-noninvasive ratio of 2.4:1 (45:19) and 1.0:1 (18:18) (p = 0.043), respectively. The overall positive predictive value (PPV) was 76% (124/164) for mammography and 68% (152/222) for MRI (not significant). In breasts with an almost entirely fatty pattern, sensitivity was 75% for mammography and 80% for MRI (not significant), and the PPV was 73% and 65% (not significant), respectively. In breasts with fibroglandular or dense pattern, the sensitivity was 60% and 81% (p < 0.001), and the PPV was 78% and 71% (not significant), respectively. CONCLUSION: MRI was more sensitive than mammography for the detection of multiple malignant foci in fibroglandular or dense breasts. Mammography missed larger and more invasive cancer foci than MRI. A relatively low PPV was a problem for both techniques. 相似文献
913.
目的利用磁共振电影成像研究冠状动脉的运动规律.方法选取不同心率的志愿者35例,使用电影成像序列显示冠状动脉断面的运动轨迹,以5% R-R间期为标准化时间单位(NTU),分析冠状动脉运动轨迹和速度的特征.结果冠状动脉各分支的运动轨迹存在个体差异.当心率小于75 bpm时,RCA和LCX在ECG触发延迟75% R-R的舒张中期和40% R-R的收缩末期运动速度小于3 mm/NTU,LAD在整个心动周期运动速度基本都小于3 mm/NTU.结论心率小于75 bpm时,建议选择舒张中期进行冠状动脉的断层采样或者重建. 相似文献
914.
MR Nolan Cert Ed BEd MA SRN RMN Nurse Teacher PR Jones BA SRN RHV DN 《Nurse education today》1987,7(6):258-264
With nurse education in a state of flux the opportunity exists to reappraise the teaching methods currently used and to consider which will be the most appropriate to prepare the practitioner of the future. This paper examines the possible contribution of one particular teaching medium — the academic game — by describing the development and evaluation of a new game called ‘Consolidate or bust’. The game was introduced as part of a wider programme of curriculum development aimed at providing a more balanced introductory course for new student nurses. The results to date indicate that the application of experiential methods in general, and gaming in particular, constitute a valuable addition to more formal approaches and one that may be perceived very prositively by student nurses. The paper concludes with a call for nurse educators to critically examine their present practice and consider the wider application of less formal methods. 相似文献
915.
Three‐dimensional printing enhances preparation for repair of double outlet right ventricular surgery
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Liyun Zhao MR Sijie Zhou MR Taibing Fan MD PhD Bin Li MD Weijie Liang MD Haoju Dong MD 《Journal of cardiac surgery》2018,33(1):24-27
Objective
To assess the clinical value of three‐dimensional (3D) printing technology for treatment strategies for complex double outlet right ventricle (DORV).Methods
Twenty‐five patients with complex double outlet right ventricle were enrolled in this study. The patients were divided into two groups: 3D printing group (eight patients) and a non‐3‐D printing control group (17 patients). The cardiac images of patients in the 3D printing group were transformed to Digital Imaging and Communications and were segmented and reconstructed to create a heart model. No cardiac models were created in the control group. A Pearson coefficient analysis was used to assess the correlation between measurements of 3D printed models and computed tomography angiography (CTA) data. Pre‐operative assessment and planning were performed with 3D printed models, and then operative time and recovery time were compared between the two groups.Results
There was good correlation (r = 0.977) between 3D printed models and CTA data. Patients in the 3D printing group had shorter aortic cross‐clamp time (102.88 vs 127.76 min, P = 0.094) and cardiopulmonary bypass time (151.63 vs 184.24 min; P = 0.152) than patients in the control group. Patients with 3D printed models had significantly lower mechanical ventilation time (56.43 vs 96.76 h, P = 0.040) and significantly shorter intensive care unit time (99.04 vs 166.94 h, P = 0.008) than patients in the control group.Conclusions
3D printed models can accurately demonstrate anatomic structures and are useful for pre‐operative treatment strategies in DORV. 相似文献916.
917.
918.
A randomized, controlled trial of nurse home visiting to vulnerable families with newborns 总被引:3,自引:0,他引:3
KL Armstrong JA Fraser MR Dadds & J Morris 《Journal of paediatrics and child health》1999,35(3):237-244
OBJECTIVE: This project aimed to evaluate the impact of a home visiting programme that targeted families where the child, for environmental reasons, was at great risk of poor health and developmental outcomes. METHODOLOGY: Women in the immediate postpartum period were recruited to a randomized double-blind controlled trial on the basis of self-reported vulnerability factors and were randomly assigned to receive either a structured programme of nurse home visiting, supported by a social worker and paediatrician (n = 90), or assigned to a comparison group receiving standard community child health services (n = 91). Parenting stress and maternal depression were measured at enrollment and at 6 weeks. Preventive health behaviour, service satisfaction and home environment outcomes were tested at 6 weeks, as were child health outcomes. RESULTS: At six weeks, women receiving the home-based programme had significant reductions in postnatal depression screening scores as well as improvements in their experience of the parental role and improvement in the ability to maintain their own identity. Maternal-infant interactions were more likely to be positive, with significantly higher (better) scores in aspects of the home environment related to optimal development in children, particularly maternal-infant secure attachment. Intervention group mothers were significantly more satisfied with the community child health service. CONCLUSIONS: This form of intervention for families is effective in promoting secure maternal-infant attachment, preventing maternal mood disorder and is welcomed by the families receiving it. These findings may predict long-term benefits for the healthy development of children otherwise at risk of a range of poor health and development outcomes. 相似文献
919.
JP Slavotinek S Fowler MR Sage BP Brophy 《Journal of Medical Imaging and Radiation Oncology》1999,43(1):111-112
Cavernous haemangiomas confined to the epidural space are rare and are therefore infrequently considered in the differential diagnosis of spinal epidural masses. In order to draw attention to this diagnosis, a case in which an epidural cavernous haemangioma simulates a lateral/foraminal disc protrusion is presented. 相似文献