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11.
Levente Gáspár Zoltán Jónás László Kiss György Vereb Zoltán Csernátony 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2009,19(6):403-407
Background Coccygodynia can cause severe pain and disability in patients. There are contradictions in the literature regarding the final
results of coccygectomy for coccygodynia. We evaluated the long-term effects of coccygectomy on the intensity, characteristics,
and manifestation of pain caused by coccygodynia to determine the adequacy of operation among treatment modalities.
Materials and methods Thirty-four patients with coccygodynia were treated by coccygectomy. In 22 cases, trauma, and in one case childbirth was the
cause. 11 cases were regarded as idiopathic. The intensity, characteristics of pain, and the most painful activities were
evaluated at an average of 7.6 (3–18) years of follow-up time.
Results Before the operation, all 34 patients had pain while sitting, moreover, 26 of them had pain during standing, walking, at night
or a combination of these. 21 patients had intolerable or very intensive, mainly acute, sharp or burning pain. 11 patients
had dyschesia, 2 had dysuria and 6 had dyspareunia. At follow-up, 7 patients were completely free of pain, 15 others had moderate,
11 medium, and only one patient had severe, but none had intolerable pain. Only seven patients had acute, sharp or burning
pain postoperatively. The decrease of average pain score from 8.0 to 3.2 was significant (P < 10−12). The number of the patients with dyschesia and dyspareunia decreased from 11 to 7 and from 6 to 3, respectively. Two patients
had dysuria, but their complaints did not change after the operation. One of the two patients who needed reoperation had an
excellent final result, while the other remained unchanged. 12 and 16 patients (together 82%) regarded the final result of
the operation excellent and good, respectively. The condition of five others did not change, while one became worse. The patients
with younger age, smaller body mass index, and less co-morbidities had better final result. There were no serious complications.
Conclusion Coccygectomy for coccygodynia is a safe method to decrease the intensity of pain and other complaints of the patients. The
operation can be the choice of treatment if conservative measures fail. 相似文献
12.
Evaluation of students undertaking fieldwork education placements is a critical process in the health professions. As training programs and practice evolve, systems for assessing students need to be reviewed and updated constantly. In 1995, staff of the occupational therapy training program at the University of Queensland, Australia decided to develop a new tool for assessing student fieldwork performance. Using an action research methodology, a team developed the Student Placement Evaluation Form, a flexible and comprehensive criterion-referenced evaluation tool. The present paper examines action research as an appropriate methodology for considering real-life organisational problems in a systematic and participatory manner. The action research cycles undertaken, including preliminary information gathering, tool development, trial stages and current use of the tool, are detailed in the report. Current and future development of the tool is also described. 相似文献
13.
Vandana Jain Supriya Dabir Debraj Shome Tina Dadu Sundaram Natarajan 《Survey of ophthalmology》2009,54(2):286
We report the case of a 25-year-old male patient who presented with complaints of redness, photophobia, and decreased vision in the right eye of a week's duration. Slit-lamp biomicroscopic examination revealed a cream-colored, irregular elevated inferior iris mass, extending on to the anterior lens surface. Differential diagnoses of a fungal granuloma, a medulloepithelioma, and an amelanotic melanoma were considered. An excisional biopsy of the mass was performed through a superior clear corneal incision. Polymerase chain reaction analysis of the aqueous humor showed a positive pan fungal genome. Histopathology of the biopsied mass showed a giant cell granuloma with surrounding numerous branching, septate hyphae. Culture growth revealed Aspergillus fumigatus We report this case because of the rarity of Aspergillus iris granuloma as a primary presentation of endogenous Aspergillosis and review the relevant literature. Absence of a significant systemic history compounded the diagnostic dilemma in our patient. Definitive differentiation of this rare entity from a foreign body, amelanotic melanoma, and other inflammatory conditions such as sarcoidosis and tuberculosis, may be possible only on microbiological and histo-pathological evaluation. 相似文献
14.
学生课堂教学质量评价问题浅析 总被引:1,自引:0,他引:1
综合分析河南中医学院近三年以来学生课堂教学质量评价反馈的信息,认为引发课堂教学评价偏差的人为因素有评价者的能力水平、责任心、情感倾向。其对策为:改变教师的被动地位,进一步修订评价体系,加强对组织评价者的培训,强化临床课的教学,进一步提高学生的认识,跟踪调查课堂教学质量评价。 相似文献
15.
重视药物利用评价研究,开展药物利用评价活动 总被引:1,自引:1,他引:0
药物利用评价是当前医院合理用药的深入发展的重要体现,也是临床药学的重要工作之一。本文论述了药物利用评价的目的、意义、方法和进展,以及药物利用评价在医院药房中的应用,以期引起有关人员的重视。 相似文献
16.
Summary UK health policy requires child and adolescent mental health service providers to demonstrate that their services are effective.
The FOCUS project has been developed to improve the availability and accessibility of research evidence and innovation, to
support purchasers in the effective commissioning of services and to help providers base service provision on evidence of
effectiveness and develop methods of evaluation. 相似文献
17.
P. Croft D. A. White C. M. D. Wiskin T. F. Allan 《European journal of dental education》2005,9(1):2-9
This paper reports student (n = 180) feedback on the role-play teaching methodology used in behavioural sciences teaching at The School of Dentistry in Birmingham (UK). The feedback received on this well-established (since 1995) educational programme was collected via questionnaire (100% response rate), requiring Likert scale and free text responses. Generally students reported that they had enjoyed and valued the session. Over two-thirds (69.7%) of students rated the role-players as 'very real' and over three-quarters (78.9%) rated their feedback as 'very fair'. The data collected from this study will inform future curriculum development. Student feedback was very positive and demonstrated that the cohort (86% of all students studying in years 1, 2 and 3) found the use of professional role-players involved in behavioural sciences teaching to be both acceptable and valuable. 相似文献
18.
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
19.
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
20.