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41.
Bilateral traumatic caroticocavernous fistulae: total resolution following unilateral occlusion 总被引:1,自引:1,他引:0
Balloon occlusion is the accepted treatment for direct post-traumatic caroticocavernous fistula. We present a case of bilateral
traumatic fistulae associated with a pseudoaneurysm. Resolution of both fistulae occurred following treatment of one of them
by balloon occlusion of the internal carotid artery. This case highlights the importance of considering a more conservative
approach to bilateral fistulae or those associated with a pseudoaneurysm. We review other treatment options.
Received: 1 October 1999/Accepted: 20 October 1999 相似文献
42.
Kathleen M. Gillespie 《Canadian Medical Association journal》2006,175(2):165-170
Type 1 diabetes results from the autoimmune destruction of insulin-producing β cells in the pancreas. Genetic and, as yet undefined, environmental factors act together to precipitate the disease. The excess mortality associated with the complications of type 1 diabetes and the increasing incidence of childhood type 1 diabetes emphasize the importance of therapeutic strategies to prevent this chronic disorder. Why is it considered that type 1 diabetes might be preventable? Different strands of diabetes research are coming together to suggest therapeutic targets. Islet cell autoantibody assays make it possible to accurately identify people at risk of future disease. In most cases, a long prodrome provides a window of opportunity to reverse the autoimmune process. Although no current “cure” exists, recent genetic data and preliminary trial results suggest T cells as a target for preventive strategies. Another potentially attainable target is induction of tolerance to the β-cell proteins such as insulin that are inappropriately recognized. Other strategies involve β-cell replacement, but currently there are insufficient donor cells available. This may be overcome as the processes controlling the differentiation of pancreatic and nonpancreatic progenitors as well as replication of existing islet β cells are unravelled. 相似文献
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Suzanne M. Gillespie Andrea L. Moser Murthy Gokula Thomas Edmondson Joseph Rees Dallas Nelson Steven M. Handler 《Journal of the American Medical Directors Association》2019,20(2):115-122
Objectives
This document offers guidance to clinicians and facilities on the use of telemedicine to deliver medically necessary evaluation and management of change of condition for nursing home residents.Settings and participants
Members of the telemedicine workgroup of AMDA—The Society for Post-Acute Long-Term Medicine-developed this guideline through both telephonic and face-to-face meetings between April 2017 and September 2018. The guideline is based on the currently available research, experience, and expertise of the workgroup's members, including a summary of a recently completed systematic mixed studies literature review to determine evidence for telemedicine to reduce emergency department visits or hospitalizations of nursing home residents.Results
Research and experience to date support the use of telemedicine as a tool in change of condition assessment and management as a means of reducing unnecessary emergency department visits and hospitalization. Telemedicine-delivered care should be integrated into the primary care of the resident and delivered by providers with competency in post-acute long-term care. The development and sustainability of telemedicine programs is heavily dependent on financial implications. Quality measures should be defined for telemedicine programs in nursing homes.Conclusions/Implications
Telemedicine programs in nursing homes can contribute to the delivery of timely, high quality medical care, which reduces unnecessary hospitalization. Reimbursement for telemedicine-driven care should be based upon medical necessity of visits to care and the maintenance of quality standards. More studies are needed to understand which telemedicine tools and processes are most effective in improving outcomes for nursing home residents. 相似文献49.
Sk Masum Billah Tarana E. Ferdous Abu Bakkar Siddique Camille RaynesGreenow Patrick Kelly Nuzhat Choudhury Tahmeed Ahmed Stuart Gillespie John Hoddinott Rukhsana Haider Purnima Menon Shams El Arifeen Michael J. Dibley 《Maternal & child nutrition》2022,18(3)
Exclusive breastfeeding (EBF) for the first 6 months has established benefits, yet had slow improvements globally. Little is known about electronic job aid‐assisted counselling to support EBF. As a secondary outcome of a cluster randomized controlled trial in Bangladesh, we assessed the effect of electronic job aid‐supported nutrition counselling and practical demonstration on EBF. We randomized pregnant women to one of five study arms in the trial and followed mother–child dyads until 2 years of age. Community health workers (CHWs) provided breastfeeding counselling with or without prenatal and complementary nutrient supplements in all four intervention arms. The comparison arm continued with the usual practice where mothers could receive nutrition counselling at routine antenatal and postnatal care, and during careseeking for childhood illnesses. We assessed breastfeeding indicators at birth and monthly until the child was 6 months old, in both intervention and comparison arms. To evaluate the effect of nutrition counselling on breastfeeding, we combined all four intervention arms and compared them with the comparison arm. Intervention newborns had half the risk (relative risk [RR]: 0.54, 95% confidence interval [CI]: 0.39, 0.76) of receiving prelacteal feeds than those in the comparison arm. EBF declined steeply in the comparison arm after 3 months of age. EBF was 16% higher in the intervention than the comparison arm at 4 months (RR: 1.16, 95% CI: 1.08, 1.23) and 22% higher at 5 months of age (RR: 1.22, 95% CI: 1.12, 1.33). Maternal background and household characteristics did not modify the intervention effect, and we observed no difference in EBF among caesarean versus vaginal births. Breastfeeding counselling and practical demonstration using an electronic job aid by CHWs are promising interventions to improve EBF and are scalable into existing community‐based programmes. 相似文献
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