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51.
Christopher L. Knight MD Henry A. Sakowski MD Bruce L. Houghton MD Mary B. Laya MD MPH Dawn E. DeWitt MD MSc 《Journal of general internal medicine》2004,19(5P2):594-598
The World Wide Web creates new challenges and opportunities for medical educators. Prominent among these are the lack of consistent standards by which to evaluate web-based educational tools. We present the instrument that was used to review web-based innovations in medical education submissions to the 2003 Society of General Internal Medicine (SGIM) national meeting, and discuss the process used by the SGIM web-based clinical curriculum interest group to develop the instrument. The 5 highest-ranked submissions are summarized with commentary from the reviewers. 相似文献
52.
目的 总结我市结核病控制项目实施效果和经验。方法 根据全市各县(区)上报的结核病报表和有关总结材料进行分析。结果 在项目实施期间发现涂阳病人7522例,治愈了7303例,涂阳病人登记率从1993年的8.2/10万提高到2001年的39.4/10万,初、复治涂阳病人治愈率从1992年的80.0%和81.8%提高到2001年的98.9%和96.2%。结论 我市结核病控制项目实施效果显,项目所取得的成功经验和技术策略对今后结核病控制可持续发展有着重要的指导作用。 相似文献
53.
Summary: For the quantitative determination of the testicular size or volume, two groups of apparatus are available: on the one hand, model testes, which are extremely valuable in longitudinal and cross-sectional studies during the period of pubescence, and on the other hand, measuring devices, with which the testicular dimensions can be specified. The latter instruments are helpful chiefly during the adolescent years and the diagnosis of problems surrounding fertility. The testicular volume can be calculated subsequently from the specific testicular measurements. The formula, for computing the volume of an ellipsoid, seems to be the most suitable for this purpose. Appliances also have been developed, which allow the largest (longitudinal) dimension (in mm) and the testicular volume (in cm3) to be read off simultaneously. A tonometer can be useful to quantitatively estimate the testicular consistency, which is a parameter of the testicular integrity at the level of tubular function (spermatozoa production). 相似文献
54.
Devi Kanikanti Padmalatha Rao Kanikanti V. Ranga Baveja Srikrishan Fathi Marc Roth Marc 《Pharmaceutical research》1989,6(4):313-317
Zero-order release of oxprenolol hydrochloride was obtained by controlling the swelling and erosion of the matrix. This formulation involves only mixing of drug, hydroxypropylmethylcellulose (HPMC), and sodium carboxymethylcellulose (Na CMC) at the ratio of 1:0.4:1.6, respectively, and compressing the mixture directly into tablets. The in vitro release pattern from this optimized matrix tablet was reproducible. Accelerated stability studies revealed that the optimized formulation remains stable for an approximately 2-year shelf life. This sustained-release (SR) tablet was evaluated in dogs, and for comparison a conventional (CV) formulation was also given at the same dose level. Plasma oxprenolol levels were monitored by a sensitive and specific high-performance liquid chromatographic (HPLC) method. Significant differences in the pharmacokinetic parameters, i.e., lower C
max, higher values of t
max, MRT, AUC, and plasma concentration at 24 hr, and nearly constant plasma levels over 12 hr, indicated that the SR matrix tablet is superior to the CV rapid-releasing formulation. The in vitro release parameters and in vivo pharmacokinetics correlated well. 相似文献
55.
喻观培 《中国卫生质量管理》2007,14(6):16-19
病案作为记录医疗活动过程的重要载体,包含着各类丰富的信息。医疗服务质量评价有很多内容是通过病案实现的。作者分析了包括"三级医师查房"在内的20余项在病案中反映的医疗服务质量项目,指出影响质量判断的常见因素,并提出解决的对策与措施。 相似文献
56.
用秩和比法对我院的10个公示病种医疗质量进行综合评价 总被引:2,自引:0,他引:2
目的对我院2005年度公示的10个病种进行医疗质量综合评价。方法采用秩和比法(RSR)进行统计分析。结果我院的10个公示病种被划分成4个医疗质量等级:老年性白内障、小儿支气管肺炎2个病种质量为优,急性阑尾炎、腹股沟疝(单侧)、子宫平滑肌瘤、剖宫产4个病种质量为良,胃大切、脑梗塞、急性心肌梗塞3个病种质量为中,脑出血1个病种质量为差。结论通过对综合指数秩和比(RSR)的计算并根据其值分级归档,反映出所研究病种之间存在着医疗质量高低的差异。控制和降低本院临床常见病种的医药费用,进行医疗全程连续性控制,为患者提供经济有效的医疗服务。 相似文献
57.
目的 探讨肱骨髁间骨折的手术方式并评价疗效。方法 1998年1月~2004年12月共手术治疗肱骨髁间骨折28例,进行随访分析。结果 28例中26例获随访,时间6个月~4年7个月,其中22例获2年以上随访。疗效评价参照casse‰。评分系统,优良率为65%。结论 骨折类型及手术方式直接影响预后。关节良好的复位和牢固的固定,以及术后早期积极的功能锻炼是得到良好疗效的保证。 相似文献
58.
Retrospective review of the preoperative biliary and gastrointestinal evaluation for gastric bypass surgery 总被引:1,自引:0,他引:1
Vincent W. Vanek M.D. C.N.S.P. F.A.C.S. Michele Catania R.N. B.S.N. Kimberly Triveri R.D. L.D. Robert W. Woodruff Jr M.D. 《Surgery for obesity and related diseases》2006,2(1):839-22
BACKGROUND: The purpose of this study was to analyze the frequency and results of preoperative biliary and gastrointestinal (GI) evaluation of patients undergoing Roux-en-Y gastric bypass (RYGB). METHODS: Retrospective review of the preoperative evaluation of 144 consecutive RYGB patients. RESULTS: Cholecystectomy had already been performed in 43 (30%) patients; 22% of those patients with an intact gallbladder had cholelithiasis. Ten patients (7%) had an upper GI x-ray (UGI), and 94 patients (65%) had an esophagogastroduodenoscopy (EGD). Abnormalities were found in 40% of the UGIs and 84% of the EGDs. A total of 96 patients (67%) were tested for Helicobacter pylori; 11% were positive. Twenty-one patients (15%) underwent preoperative colonoscopy; 48% were abnormal, but most of the abnormalities were not clinically significant. Three patients had barium enema x-ray, which was normal in all cases. CONCLUSIONS: The preoperative biliary and GI evaluation of bariatric surgery patients should include a routine ultrasound of the gallbladder. Routine preoperative EGD will detect a significant number of abnormalities that should be treated, but should rarely alter the bariatric surgical procedure or result in denial of bariatric surgery. Many abnormalities will be asymptomatic. Patients should be routinely screened for H. pylori and, if positive, treated before bariatric surgery. Lower GI evaluation should be performed selectively based on the patient's symptoms, physical findings, and guidelines for colorectal cancer and polyp screening. 相似文献
59.
D De AJ Kanwar S Handa 《Journal of the European Academy of Dermatology and Venereology》2006,20(7):853-859
BACKGROUND: Diagnosis of atopic dermatitis (AD) depends on clinical features because no definitive diagnostic test exists. Criteria proposed by Hanifin and Rajka (Acta Derm Venereol (Stockh) 1980; Suppl 92: 44-47) were acceptable for hospital-based studies but were found not to be suitable for field studies. A UK working party formulated clinical diagnostic criteria that could be used in both hospital and epidemiological settings. Validation studies of the criteria showed widely variable results, probably due to different clinical settings and ethnicity. AIM AND OBJECTIVE: This study was undertaken to validate Hanifin and Rajka's criteria and to assess the comparative efficacy of their criteria and the UK working party's diagnostic criteria in the diagnosis of AD in a hospital setting in North India. SUBJECTS AND METHODS: This study serially included 101 patients with AD and 48 controls of paediatric age group. The study period was from July 2003 to December 2004. RESULTS: Hanifin and Rajka's criteria (sensitivity 96%, specificity 93.75%, positive predictive value 97% (PPV) and negative predictive value (NPV) 91.84%) had a statistical advantage over the UK working party's diagnostic criteria (sensitivity 86%, specificity 95.83%, PPV 97.75% and NPV 76.67%), with a P-value < 0.005. 相似文献
60.
TAKAKO EGUCHI TAKUJI GOTODA ICHIRO ODA HISANAO HAMANAKA NORIAKI HASUIKE DAIZO SAITO 《Digestive endoscopy》2003,15(2):113-116
Background: Endoscopic mucosal resection (EMR) is widely accepted as a minimally invasive treatment for early gastric cancer (EGC) in Japan. However, the criteria for EMR must be strictly adhered to otherwise patients will miss the chance for additional therapy. We assess the important factor in expanding the indication of EMR. Methods: We investigated 1101 EGCs that had been resected by EMR at the National Cancer Center Hospital (NCCH), Tokyo, Japan, according to the indication recommended by Japanese Gastric Cancer Association (JGCA) and the expanded indication proposed by NCCH. Curability and local recurrence of the EMRs were assessed related to the applied indication and the number of resected specimens. Results: The recurrence rate of non‐evaluable resection was higher than that of evaluable resection (P < 0.0001). Eighty‐three lesions among 772 lesions in the JGCA group were non‐evaluable. Thirty‐seven leisons among 329 lesions in the NCCH group were non‐evaluable. There was no difference in the rate of non‐evaluable resection between JGCA and NCCH groups (P = 0.8329). However, the rate of curative resection was lower in the NCCH group than in the JGCA group (P = 0.0009). In piecemeal resection, there was no difference in the rate of non‐evaluable resection between JGCA and NCCH groups (P = 0.0527). In one‐piece resection, the rate of non‐evaluable resection was lower in the NCCH group than the JGCA group (P = 0.0137). Conclusion: Based on our series of cases, we propose one‐piece resection as a gold standard for EMR because it enables accurate histological evaluation, even in the EMR, according to the expanded indication. 相似文献