浮动髋的治疗(附11例报告)

浮动髋系同侧骨盆骨折和股骨骨折。我院自1985年以来收治浮动髋11例。按Tile分类,骨盆骨折A_1型1例,A_2型3例,B_1型1例,B_2型2例,C_2型2例,C_3型2例。同侧股骨干骨折8例,股骨粗隆间骨折2例,股骨颈骨折1例。骨盆骨折均给予保守治疗,下肢骨折内固定4例,保守治疗7例。9例获平均4年的随访,结果优6例,良2例,差1例。     

Rapid quantitation of mixed red cell populations using flow cytometry

Methods are described for the identification and quantitation of mixed red cell populations using flow cytometry. Antibodies specific for a wide range of blood group antigens have been used and examples are given in which these analyses have proved to be of clinical use. These examples include monitoring of erythropoiesis following engraftment in allogeneic bone marrow transplant recipients and the detection of chimaeric states months or years after transplantation. The techniques involved are fast, simple and inexpensive.     

Women's programs versus mixed-gender day treatment: results from a randomized study

AIMS: To compare outcomes and costs of out-patient women's treatment to mixed-gender programs. DESIGN: Randomized clinical trial. SETTING: Northern California (USA). INTERVENTION: Day treatment: one community-based women's program, two mixed-gender community-based programs and one mixed-gender hospital-based program. PARTICIPANTS: Substance-dependent women recruited from the community (n = 122). MEASUREMENTS: Women were interviewed at baseline, at the end of treatment (94% response rate) and at 6 and 12 months post-treatment (100% response rates). Measures included alcohol and drug use, and psychiatric and social problems. Program costs were estimated using the Drug Abuse Treatment Cost Analysis Program. FINDINGS: No significant differences between the women's program and any of the mixed-gender programs were found for psychiatric problem severity, problems with family and friends or rates of drug use at any of the follow-up points. Rates of alcohol abstinence and total abstinence were similar between the women's program and both of the mixed-gender community programs, but were higher at the mixed-gender hospital program. Only one of these results was replicated in the multivariate analysis, with the odds of total abstinence significantly lower for those randomized to the women's program than the mixed-gender hospital program. However, the average cost of a treatment episode was significantly higher at the hospital program than at the women's program (1212 US dollars versus 543 US dollars). CONCLUSIONS: These findings suggest that female substance abusers may be treated as effectively in mixed-gender programs as in women's programs.     

Fatherhood and the meaning of children: an ethnographic study among Puerto Rican partners of adolescent mothers

This study of the male partners of adolescent mothers was conducted in a small urban city in the northeastern United States where adolescent birth rates remain high despite declining national trends. Despite stated opposition to adolescent birth, one third of the fathers interviewed planned their pregnancies with their partners for more than a year. Because poverty and violence were part of life in the community of these fathers, the experience of having children initiated self-reflection. Men did not value absence from their children's lives, and they recognized their own agency in constructing a fatherless reality for their children. Thus, having children gave men an opportunity to consider alternative possibilities for their lives. This study suggests that despite widespread efforts to prevent teenage pregnancy, children born to adolescent mothers provide the fathers of these children with an affirming and valued component of self-identity.     

Bipolar dislocation of the clavicle: 3D CT imaging and delayed surgical correction of a case

I report a case of traumatic floating clavicle in a woman aged 18 years, successfully treated 19 days after the accident by bipolar open reduction and wire stabilization. The pertinent literature is briefly reviewed.     

Relationships between brachial-ankle pulse wave velocity and conventional atherosclerotic risk factors in community-dwelling people

BACKGROUND: A simple instrument has been developed to measure brachial-ankle pulse wave velocity (baPWV). The aim of the present study was to use this instrument to study the relationship between baPWV and conventional atherosclerotic risk factors. METHODS: Community-dwelling Japanese (632) living in a rural area (234 men and 398 women) participated in a municipal medical health survey that included baPWV measurement and a traditional clinical examination, conducted in June, 2002. RESULTS: Men had a significantly higher baPWV than women. No interaction between gender and age on baPWV was identified. Multiple linear regression analysis indicated that age, hemodynamic factors (diastolic blood pressure, pulse pressure, and heart rate), hemoglobinA1c, current drinking and smoking status, and mild retinal changes had significant independent influences on higher baPWV. CONCLUSIONS: In this rural population, age, gender, and hemodynamic factors were independently associated with baPWV, along with traditional atherosclerotic risk factors, although no significant associations between baPWV and histories of atherosclerotic diseases or subclinical atherosclerosis except for mild retinal changes were demonstrated.     

Healthcare and the long haul: Long distance truck drivers--a medically underserved population

BACKGROUND: Long distance trucking is associated with significant health risks. However, to our knowledge no published data exist regarding healthcare service access by the estimated two million long-haul truckers in the United States. METHODS: A cross-sectional study was designed to assess access to healthcare among these workers. Five hundred-twenty-one anonymous self-administered surveys were completed at 16 truck stops in 14 states from July through August 2002. RESULTS: Forty-seven percent of those surveyed lack a regular healthcare provider, 20% frequent emergency rooms and urgent care centers, 32% were unable to receive needed healthcare within the last year, and 56% had difficulty utilizing healthcare services at home. Individuals lacking health insurance (31%) experienced more difficulty with healthcare access than the insured within the last year, were more often without a regular provider (P = 0.002 and P < 0.001), and utilized urgent care centers and emergency rooms more often than the insured (25 vs. 17%). CONCLUSIONS: Long distance truck drivers are at risk for poor health outcomes and experience significant difficulty accessing healthcare services. Further studies concerning how to best provide healthcare to this vulnerable, underserved population are needed.     

Patterns of access to public oral health care in Queensland by gender, indigenous status and rurality

Data were collected on courses of care from all attendances at public sector dental clinics between July 1994 and June 1996 and examined by gender, rurality and indigenous status. Males and indigenous people were more likely to attend dental clinics when a problem with pain existed, resulting in a high need for emergency services, more diagnoses of dental caries, and treatment more often involving oral surgery, including extractions. Similarly, remote area dwellers had more diagnoses of dental caries and oral surgery, although their attendance at clinics was complicated by access.     

Visual outcomes for remote Australian Aboriginal people after cataract surgery

Purpose : To assess the visual outcomes and quality of life after cataract surgery in Aboriginal people and compare them with a case‐matched population of non‐Aboriginal people living in remote and rural areas in the Top End of the Northern Territory. Methods : Patients living in remote areas of the Top End of the Northern Territory who underwent cataract surgery between 1994 and 1999 were identified from records at the three major hospitals in the region. Eighty‐three patients were included in the study. Each patient underwent a complete ocular assessment and then was administered a standardized, field‐tested, 12‐item questionnaire concerning visual function. This was analyzed and the results of the Aboriginal and matched non‐Aboriginal populations compared. Results : Sixty‐one Aboriginal and 22 non‐Aboriginal people from a total of 295 patients who underwent cataract surgery were included in the study. The two study groups were closely matched by sex, age at the time of surgery, time of follow up from surgery and the number who had undergone bilateral surgery. The median preoperative visual acuity for the Aboriginal group was 6/60 against 6/24 of the non‐Aboriginal group. After surgery, at the time of follow up, 26% of eyes in Aboriginal patients did not correct to 6/12 or better with pinhole approximation. Posterior capsule opacities were the most common principal postoperative cause for a deterioration of visual acuity in both groups. Postoperative trauma was a common cause for a low best‐corrected visual acuity in the Aboriginal group but not in the non‐Aboriginal group. The majority (75.5%) of Aboriginal patients were satisfied with their operated eyes. Patients who were dissatisfied all had a visual acuity worse than 6/36. Aboriginal patients reported worse visual function than did those in the non‐Aboriginal group. Conclusions : Cataract surgery has a beneficial effect on the visual acuity and quality of life of Aboriginal and non‐Aboriginal people. As compared to their non‐Aboriginal counterparts, most Aboriginal people underwent surgery when they were legally blind, had a lower level of attained postoperative visual acuity and a high incidence of uncorrected refractive errors and posterior capsular opacification requiring laser capsulotomy. The positive impact of cataract surgery on the lives of the majority of Aboriginal patients is highlighted, as is the need for continued postoperative follow up.     

Cross-sectionalStudy on Their Reproductive Health Status of 604 Fem ale Floating Residents in Beijing

This study on the reproductive health status was based on the data from a survey and an examination of several hundreds of female floating residents in Beijing.The results were compared with those from female permanent residents in Beijing.Thestudy revealed that most of the investigated female floating residents had lived in Bei-ring with their family for three years on an average.They bad a harder life than that of Beijing permanent residents.Also they did not receive adequate prenatal cares dur-ing their pregnancies in Beijing and a quarter of these mothers did not receive any pre-natal examination during their pregnancies at all.Again the females had a great prevalence of reproductive tract infections,reaching 29.3% of those examined,high-er than the women permanently residing in Beijing.