Right on target?

Targets have become an integral part of health care, whether we agree with them or not. Many accept the progress made with the use of targets, but our duty as health professionals is to ensure that their use and interpretation is undertaken with the same care and understanding of their limitations that we apply to our clinical practice, and that they are not mis-interpreted or used to justify the latest political idioms. Currently the healthcare profession is failing to understand the consequences of setting targets, or the wider implications of hitting them. This article aims to summarise how we can learn from past experiences to become more aware of the benefits and draw-backs of targets in healthcare, and how we can utilise them more efficiently in health care.     

The emerging role of ultrasound in detecting interstitial lung disease in patients with rheumatoid arthritis

ObjectiveTo investigate the potential role of US in the detection of ILD in a cohort of patients with RA.MethodsPatients with diagnosis of RA were consecutively enrolled. All patients underwent pulmonary examination, laboratory data, DLCO measure, chest HRCT and radiographs, and US examination. A healthy group was included as control group. US was performed according the 14-intercostal space scanning protocol using the following semiquantitative scale [0 = normal (≤ 5 B-lines); 1 = slight (≥ 6 and ≤ 15 B-lines); 2 = moderate, (≤ 16 and ≥ 30 B-lines); 3 = severe (≥ 30 B-lines)].ResultsA total of 74 RA patients and 74 healthy controls were included. Thirty of 74 patients (40.5%) showed US signs of ILD with respect to the healthy controls (3 subjects, 4.1%) (P < 0.001); whereas HRCT showed ILD in 27 (36.4%) of 74 patients. Among the 30 patients that showed US findings of ILD, 17 (56.6%) were asymptomatic from respiratory view-point. The sensitivity and specificity of US were 92% and 89% respectively. A positive correlation between US and HRCT findings were found (P < 0.001) whereas no correlation was found with chest radiographs and DLCO findings. Positive association between US findings and DAS28-ESR, anti-CCP and RF (P < 0.01 for each respectively) was found. Feasibility, represented by the mean time spent to perform the pulmonary US assessment was 7.8 minutes (± SD 1.2, range 6 to 10 minutes).ConclusionsOur results support the potential of US in detect accurately ILD in patients with RA and provide a rationale to consider it as a friendly screening tool to be implemented in early phases of the disease.     

病理生理学五位一体综合理论教学法的探索

病理生理学在临床医学中具有重要作用,其理论性强的学科特点决定必需与临床密切结合才能学好病理生理学。五位体综合理论教学法的探索通过“理论教学一阶段案例分析-综合案例分析-医患互动-临床强化”等五个环节,对学生所学内容进行逐级强化,不仅使其对所学的每一个章节都能够及时理解和把握,而且能够彼此联系、融汇贯通,分析具体问题游刃有余,从而达到最佳的教学效果。     

网络技术下图书编目工作的变革

本文从编目范围的扩大、编目手段的变化、文献编目的 深层揭示、编目人员素质提高4个方面,论述了图书馆杯准化、自动化的实施对图书馆期刊编目工作带来的变革.     

感染管理科职业安全防护探讨

文章通过分析医院感染管理科工作人员的职业危害因素,对院感工作人员职业安全防护的重要性予以强调,并提出相应的防护措施。     

医疗损害纠纷处理机制存在问题及解决措施

目的分析云南省医疗损害纠纷处理机制存在的问题,提出解决方略。方法对云南省2001～2007年的医疗损害纠纷情况进行分析,剖析现有处理机制存在的问题以及由此带来的社会问题。结果提出处理医疗损害纠纷的解决方案。结论医疗损害纠纷是社会问题,应当从社会管理的高度建立医疗损害处理机制。     

浅谈当代冠心病的预防及药物治疗

目的冠心病是当代威胁人类生命健康的疾病之一。随着人类生活的改善,肥胖、高血脂、高血压、糖尿病等疾病有所上升,给预防和治疗冠心病带来了新的问题。针对新问题,采取新措施,预防和治疗冠心病对人类生命健康尤为重要。方法通过对新问题的列举和分析。结论对预防和治疗冠心病提出相应措施。