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171.
Rashmi Kothari MD Kent Hall MD Thomas Brott MD Joseph Broderick MD 《Academic emergency medicine》1997,4(10):986-990
Objective : To develop an abbreviated and practical neurologic scale that could assist emergency medical services or triage personnel in identifying patients with stroke.
Methods : A prospective, observational, cohort study was performed at university-based EDs. Participants were 74 patients treated in a thrombolytic stroke trial and 225 consecutive non-stroke patients evaluated during 4 random 12-hour shifts in the ED. Scores on the NIH Stroke Scale were obtained for all patients by physicians. Items of this scale were modified and recoded to a binomial (normal or abnormal) scale. Serial univariate analyses using χ2 were performed to rank items. Recursive partitioning was then performed to develop the decision rule for predicting the presence of stroke.
Results : Three items identified 100% of patients with stroke: facial palsy, motor arm, and dysarthria. An Abbreviated NIH Stroke Scale based on these items had a sensitivity of 100% and a specificity of 92%. A proposed Out-of-hospital NIH Stroke Scale consisting of facial palsy, motor arm, and a combination of dysarthria and best language items (abnormal speech) had a sensitivity of 100% and a specificity of 88%.
Conclusion : Using the derivation data set, a proposed Out-of-hospital NIH Stroke Scale had a high sensitivity and specificity for identifying patients with stroke when performed by physicians in this group of 299 ED patients. Prospective studies of other health care professionals using the scale in the out-of-hospital arena are needed. 相似文献
Methods : A prospective, observational, cohort study was performed at university-based EDs. Participants were 74 patients treated in a thrombolytic stroke trial and 225 consecutive non-stroke patients evaluated during 4 random 12-hour shifts in the ED. Scores on the NIH Stroke Scale were obtained for all patients by physicians. Items of this scale were modified and recoded to a binomial (normal or abnormal) scale. Serial univariate analyses using χ
Results : Three items identified 100% of patients with stroke: facial palsy, motor arm, and dysarthria. An Abbreviated NIH Stroke Scale based on these items had a sensitivity of 100% and a specificity of 92%. A proposed Out-of-hospital NIH Stroke Scale consisting of facial palsy, motor arm, and a combination of dysarthria and best language items (abnormal speech) had a sensitivity of 100% and a specificity of 88%.
Conclusion : Using the derivation data set, a proposed Out-of-hospital NIH Stroke Scale had a high sensitivity and specificity for identifying patients with stroke when performed by physicians in this group of 299 ED patients. Prospective studies of other health care professionals using the scale in the out-of-hospital arena are needed. 相似文献
172.
173.
对10例经手术证实的肝包虫囊肿(又称细粒棘球蚴病)的磁共振成像(MRI)进行分析,认为其特征性表现为:囊壁呈光滑厚薄均一的低信号的包膜,在T2加权像上显示更加清楚;母囊内有数个大小不等的子囊,整个病灶呈多房性似玫瑰花状。本文对肝包虫囊肿与肝内其它囊性占位病变的鉴别诊断进行了探讨。 相似文献
174.
《International journal of nursing terminologies and classifications》1992,3(3):117-123
A number of persistent issues in the nursing diagnosis community have challenged the ability of one nursing diagnosis taxonomy to account for nursing's practice. The North American Nursing Diagnosis Association (NANDA) Taxonomy Committee, charged with the preparation of one taxonomy for all, has struggled with some of these issues and has initiated dcvelopment of axes. The issues, figuratively speaking, become the axes. The axes are intended to describe the dimensions of the human condition. This article, third in a series of four, describes the process and development of the proposed axes. 相似文献
175.
肝豆状核变性RFLP连锁分析的建立及症状前诊断和杂合子检出的研究 总被引:5,自引:0,他引:5
RB1基因位于DI3q14-21,与Wilson氏病基因紧密连锁,遗传距离为4.4cm(centimorgan),其3'端第17号内含子中p68RS2.0标记的等位片段与白种人相同,但基因频率存在差异,杂合子频率为43%。应用该标记对11个WD家系进行RFLP连锁分析,检出3名症状前患者,11名杂合子及3名正常纯合子,证实p68RS2.0标记可用于Wilson氏病的症状前诊断及杂合子筛选。 相似文献
176.
目的 探讨脾结核的临床特点、诊断和治疗。方法 回顾性分析经临床、手术及病理证实的11例脾结核的临床特征。结果 11例患者中,男7例,女4例,平均年龄29岁。6例术后证实,5例经内科保守治疗后证实。多数患者表现为发热、消瘦、血沉增快、贫血、脾肿大,B超发现脾脏肿大11例,其中8例脾内多发占位,3例为孤立性占位;7例行CT检查,6例发现脾脏多发性大小不等的结节状低密度灶,1例为单发类圆形低密度影,边缘不清,增强扫描病灶内部无强化;6例患者伴后腹膜、脾门区等淋巴结肿大,5例患者伴其它脏器结核。结论 不明原因发热、消瘦、血沉增快、贫血、脾肿大为脾结核的主要临床表现,腹部B超和腹部CT能对脾结核作出较准确的判断,脾结核患者经正规治疗可治愈。 相似文献
177.
178.
对60例病毒性肝炎患者进行肝穿刺活检,结果发现,临床与病理诊断的符合率为46.6%,其中,急性肝炎的诊断符合率最低(23.8%),慢性迁延型肝炎(慢迁肝)为44.8%;HBsAg阳性首次发病的患者中,急性乙型肝炎仅为11.2%(2/18);临床诊断的慢性活动型肝炎(慢活肝)仅为病理检出的25.7%(9/35);肝炎患者中脾肿大,凝血酶元时间延长、A/G值<1.2、抗HBcIgM阳性可作为慢活肝与慢迁肝鉴别的重要指标。这些对提高病毒性肝炎临床分型诊断的准确率及指导临床治疗有意义。 相似文献
179.
陈锡慰 《南京医科大学学报(英文版)》1994,(1)
AStudyonUsingImprovedMethenamine-silverStaintoDiagnosisofPneumocystiscariniiChenXiwei(陈锡慰)(DepartmentofParasitology,NanjingMe... 相似文献
180.