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1.
Dane Scantling Robert Kucejko John Williamson Alvaro Galvez Amanda Teichman Ryan Gruner Nicholas Serniak Brendan McCracken 《Injury》2019,50(1):54-60
Background
Most elderly trauma patients suffer blunt head injury and many utilize antithrombotic (AT) medications. The utility of delayed CT-head (D-CTH) in neurologically intact elderly patients using AT who have an intracranial hemorrhage (ICH) on presentation is unknown. We hypothesized that D-CTH would not alter clinical management and aimed to evaluate the role of D-CTH in this population.Methods
A retrospective cohort study was performed. Patients ≥65 years sustaining blunt head injuries from January 2010 to July 2017 were identified using our level 1 trauma center database. AT-patients presenting with ICH who underwent D-CTH were included. Patients with worsened ICH were compared to those with stable to improved ICH on D-CTH. AT-patients were compared to a cohort of non-AT patients. Fisher’s Exact and Mann-Whitney U tests were utilized and a power analysis conducted.Results
137?A?T and 34 non-AT patients were identified. There was no difference in hemorrhage progression or appearance of new ICH. No patient had a change in management from D-CTH in either cohort. AT-patients were slightly older (p?<?0.001), but cohorts were otherwise similar.50 AT-patients with worsened ICH were compared to 87 with stable ICH. There was no difference in cohort demographics. Hemorrhage progression did not vary with type of AT used but did increase if multiple types of synchronous ICH were present (p?<?0.001).Conclusions
Our data supports abstaining from routine D-CTH of elderly ICH patients with an intact neurologic examination who are utilizing aspirin, clopidogrel or warfarin. Conclusions cannot be drawn regarding new oral anticoagulants (NOACs) given low enrollment. Further multicenter study is required to provide adequate power and detect small levels of management change. 相似文献2.
3.
A case of sclerosing epithelioid fibrosarcoma and its appearance on MRI is presented. The tumor showed a zonal architecture
on MRI with a large central core of very low signal intensity and a peripheral rim of intermediate to high signal intensity
on T1- and T2-weighted spin echo pulse sequences. The core showed decreased cellularity with dense collagen deposition on
histologic examination, and the peripheral zone increased cellularity with increased nuclear atypia. The presence of a prominent
region of very low signal intensity on T1- and T2-weighted images can be seen with neural tumors, giant cell tumor of the
tendon sheath, aggressive fibromatosis, and, in rare instances, with soft tissue sarcomas rich in collagen. 相似文献
4.
W Patrick Roche Allison P Scheetz Francis C Dane David C Parish James T O'Shea 《Academic medicine》2003,78(4):398-402
PURPOSE: Studies have shown that medical students become more cynical and less altruistic as they advance in training. However, these studies were conducted in traditional medical schools, and many used unvalidated tools. This study examined students' attitudes in a problem-based learning (PBL) curriculum using reliable and valid measures. METHOD: Medical students and PGY-1 residents at Mercer University School of Medicine in Macon, Georgia, completed Wrightsman's Philosophies of Human Natures Scale (PHNS) in 1999 and 2000. Chronbach's alpha assessed internal reliability among subscales, and test-retest reliability coefficients confirmed acceptable reliability. For 114 students who completed both surveys, changes in PHNS scores were analyzed, with particular attention to the subscales of trustworthiness, altruism, and cynicism. RESULTS: Students assessed at the beginning of their second year increased the extent to which they believed people are trustworthy and increased their beliefs in how altruistic people are. They also showed a significant decrease in cynicism. There was not a significant change in trustworthiness, altruism, or cynicism among the participants beyond first year. In general, female students held less cynical views about others and believed people to be more trustworthy. CONCLUSIONS: Contrary to prior reports, this study found that more advanced trainees were not more cynical or less altruistic than their more junior counterparts. Indeed, a significant and positive change of attitudes among the participants during their first year of medical school refuted earlier reports. Thus, results of earlier studies and the effect of a PBL curriculum on attitudes of medical students need to be re-examined. 相似文献
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6.
Dane Christina Daoud MD Elena M. S. Cartagena MD MSc Katherine J. P. Schwenger RD PhD Nicha Somlaw MD Leah Gramlich MD Scott Whittaker MD David Armstrong MD Brian Jurewitsch PharmD Matreyi Raman MD Donald R. Duerksen MD James D. McHattie MD Johane P. Allard MD 《JPEN. Journal of parenteral and enteral nutrition》2022,46(2):348-356
7.
M B Casey E Winner I Hurwitz D DaSilva 《Journal of clinical and experimental neuropsychology》1991,13(4):600-606
This study investigated the effects of visual vs. verbal processing style preferences on immediate recall accuracy for the Rey-Osterrieth and Taylor Complex Figure Tests. Undergraduates were classified as visualizers or verbalizers and asked to copy either the Rey-Osterrieth or Taylor figure and then draw it from memory. A subset of subjects reported the strategy they used to reproduce the figure. Visualizers showed better reproduction accuracy than verbalizers for the Rey-Osterrieth test, and for this test approximately 80% of verbalizers as well as visualizers reported using a visual strategy. For the Taylor, no effect of processing style was obtained, and close to half of the verbalizers (43%) reported using their preferred verbal strategy, while 82% of the visualizers used a visual strategy. These results suggest that a general preference for thinking "in images" is important for predicting visual memory accuracy only on tests such as the Rey-Osterrieth which do not lend themselves easily to a verbal strategy. In contrast, for the Taylor test, deficits to the visual imagery system may be circumvented and obscured by the verbalizers' use of verbal recall strategies. Thus, in test batteries, the Rey-Osterrieth and the Taylor Tests should not be used interchangeably. 相似文献
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9.
The technical name for a surgical sponge left in the body of a patient is inadvertent “gossypiboma.” The word is derived from the Latin word Gossypium for cotton and from the Kiswahili word boma for “place of concealment.” These retained sponges were first seen as “textilomas,” but were renamed “gossypiboma” in 1978. The first case was reported by Wilson in 1884. These are rarely are retrieved in the literature, because of legal complications. A higher incidence of retained laparotomy sponges has been reported in association with gynecological procedures. We report a case of gossypiboma in the 38th week of pregnancy that imitated an ovary neoplasm. 相似文献
10.