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991.
Yu Xiong Xusheng Gao Huaiyang Zhu Caihong Ding Jian Wang 《Journal of thoracic disease》2016,8(1):52-60
Background
Fibrous tuberculous pleural effusion (TPE) represents common disease in tuberculous clinic. Medical thoracoscopy has been used to treat pleural empyema and shown promising outcomes, but data of its use in multiloculated and organized TPE remains limited to know.Methods
The study was performed on 430 cases with TPE. The cases were divided into free-flowing, multiloculated effusion and organized effusion group. Each group was subdivided into two or three types of therapeutic approaches: ultrasound guided pigtail catheter, large-bore tube chest drainage and medical thoracoscopy. Patients with multiloculated or organized effusions received streptokinase, introduced into the pleural cavity via chest tubes. The successful effectiveness of the study was defined as duration of chest drainage, time from treatment to discharge days and no further managements.Results
Patients with organized effusion were older than those with free-flowing effusion and incidence of organized effusion combined with pulmonary tuberculosis (PTB) was higher than those of multiloculated effusion and free-flowing effusion respectively. Positive tuberculosis of pleural fluid culture was higher in organized effusion than that in free-flowing effusion. Sputum positive for acid-fast bacillus (AFB) in organized effusion was higher than that in multiloculated effusion and free-flowing effusion. Medical thoracoscopy showed significant efficacy in the group of multiloculated effusion and organized effusion but free-flowing effusion. No chronic morbidity and mortality related to complications was observed.Conclusions
Medical thoracoscopy was a safe and successful method in treating multiloculated and organized TPE. 相似文献992.
News reports are the way that most people, including many physicians and scientists, first learn about new developments in medicine. Because these reports can raise awareness, influence behavior, and confer credibility, physicians should share responsibility with the media for accurate reporting. Physicians can work with reporters to avoid sensationalizing tentative findings, overstating benefits, and making inappropriate generalizations. This article includes pragmatic suggestions for crafting effective news releases and explaining numerical data. It details "rules of the road" for interviews. Working collaboratively with news reporters to improve the quality of medical stories in the lay press benefits patients and physicians alike. 相似文献
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医疗损害风险是客观存在,目前中国还缺乏有效的医疗损害风险分担机制。通过对中国医疗损害风险分
担现状的分析,就完善中国医疗损害风险分担机制建议如下:完善医疗纠纷预防处理立法;建立多层次、多渠道、
综合全面的医疗损害风险分担体系;促进各种医疗损害风险保险救助制度与医疗纠纷人民调解制度的有机衔接,构
建高效医疗纠纷化解途径等。 相似文献
997.
目的:探讨全科医学管理模式在控制老年高血压患者血压及减少心血管事件发生中的效果。方法:选择本院2010年1月-2013年1月收治的老年高血压患者2000例作为研究对象,采用随机数字表法将所选患者分成全科医学管理组(A组)、常规药物管理组(B组)及对照组(C组),比较干预前后三组患者血压改善情况及心血管事件发生情况。结果:干预后,三组患者的收缩压均较干预前降低,A组舒张压较干预前降低,A组血压改善情况优于B组及C组,B组收缩压改善情况优于C组,以上各项比较差异均有统计学意义(P0.05);随访1年后三组心血管事件发生情况比较差异有统计学意义(P0.05)。结论:全科医学管理模式可以较好的控制老年高血压患者的血压,同时可以减少心血管事件的发生。 相似文献
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Shou-Yen Chen Chung-Hsien Chaou Shiuan-Ruey Yu Yu-Che Chang Chip-Jin Ng Pin Liu 《Medicine》2021,100(24)
In-training examinations (ITEs), arranged during residency training, evaluate the residents’ performances periodically. There is limited literature focusing on the effectiveness of resident ITEs in the format of simulation-based examinations, as compared to traditional oral or written tests. Our primary objective is to investigate the effectiveness and discriminative ability of high-fidelity simulation compared with other measurement formats in emergency medicine (EM) residency training program.This is a retrospective cohort study. During the 5-year study period, 8 ITEs were administered to 68 EM residents, and 253 ITE measurements were collected. Different ITE scores were calculated and presented as mean and standard deviation. The ITEs were categorized into written, oral, or high-fidelity simulation test forms. Discrimination of ITE scores between different training years of residency was examined using a one-way analysis of variance test.The high-fidelity simulation scores correlated to the progression of EM training, and residents in their fourth training year (R4) had the highest scores consistently, followed by R3, R2, and then R1. The oral test scores had similar results but not as consistent as the high-fidelity simulation tests. The written test scores distribution failed to discriminate the residents’ seniority. The high-fidelity simulation test had the best discriminative ability and better correlation between different EM residency training years comparing to other forms.High-fidelity simulation tests had the good discriminative ability and were well correlated to the EM training year. We suggest high-fidelity simulation should be a part of ITE in training programs associated with critical or emergency patient cares. 相似文献