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排序方式: 共有944条查询结果,搜索用时 15 毫秒
1.
Josh Greenstein Devjani Das Josie Acuna Monica Kapoor Cara Brown Abbas Husain Brendan Lally Barry Hahn 《The American journal of emergency medicine》2019,37(2):313-316
Background
In the emergency department, rib fractures are a common finding in patients who sustain chest trauma. Rib fractures may be a sign of significant, underlying pathology, especially in the elderly patients where rib fractures are associated with significant morbidity and mortality. To date, no studies have evaluated the ability of ultrasound to detect rib fractures using cadaver models and subsequently use this model as a teaching tool.Objectives
The purpose of this study was to determine if it is possible to generate rib fractures on cadaver models which could be accurately identified using ultrasound.Methods
This was a cross-sectional study performed during one session at a cadaver lab. A single hemithorax from four adult cadavers were used as models. Single rib fractures on each of rib five through eight were created. Four subjects, blinded to the normal versus fractured ribs, were asked to identify the presence of a fracture on each rib.Results
A total of 8 of 16 potential ribs had fractured induced by study staff. Mean accuracy was 55% for all subjects. The overall sensitivity and specificity for detecting rib fractures was 50% (CI: 31.89–68.11) and 59.38% (CI: 35.69–73.55) respectively. The overall PPV and NPV was 55.17% and 54.29% respectively.Conclusions
In this pilot study, subjects were not able to detect induced rib fractures using ultrasound on cadaver models. The use of this model as a teaching tool in the detection of rib fractures requires further investigation. 相似文献2.
Neonatal pain management is a challenge for the clinician. Research is just beginning to uncover the neonates' capability of expression of pain, explore pharmacologic management strategies, and identify the spectrum of intrusions that may precipitate pain or distress in the critically ill neonate. This article reviews the neonatal biologic, behavioral, and physiologic responses to pain and describes recommendations for clinical management and decision-making. 相似文献
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M L Ritchey K P Lally G M Haase S J Shochat P P Kelalis 《Journal of pediatric surgery》1992,27(5):612-615
Iatrogenic injury to the aorta or its major branches during nephrectomy for Wilms' tumor in children is rarely reported but may be more common than is currently acknowledged. We identified four patients with ligation of the superior mesenteric artery (SMA) that occurred during nephrectomy for nephroblastoma and another child in whom SMA thrombosis developed postoperatively. All of the tumors were on the left side. Interruption of the SMA was recognized intraoperatively in all four children, and primary repair was done. In three patients, appearance of the bowel remained normal before repair of the injury. Three of the arteries were repaired by primary reanastomosis, and one was joined with an interpositioned hypogastric artery graft. None of these patients had gastrointestinal complications postoperatively. In the fifth patient, SMA thrombosis developed after repair of an aortic tear during nephrectomy. This patient required subsequent small bowel resection for bowel infarction and died in the perioperative period. Every surgeon treating children with Wilms' tumor should be aware of the possibly distorted vascular anatomy and take precautions to avoid such a significant injury. Attempts at early ligation of the vessels may not be justified until the renal vasculature is clearly identified. 相似文献
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A comparison of Skirrow's, Butzler's, Blaser's, Campy-BAP and Preston media for Campylobacter spp was made using human, animal and environmental specimens. Butzler's medium gave the lowest isolation rate and Preston medium, which was the most selective, the highest isolation rate. Enrichment culture using Preston enrichment broth gave a higher isolation rate than direct plating onto Preston medium. 相似文献
8.
Pfeifer JD Ashley Hill D Ramos CV Wippold FJ II Dehner LP 《Archives of pathology & laboratory medicine》2000,124(6):898-901
A 77-year-old woman with neurofibromatosis type 1 presented with ill-fitting dentures due to intraoral extension of a right temporal fossa mass. Computed tomographic scanning demonstrated that the masticator space mass bowed the zygomatic arch and remodeled the lateral orbit and maxillary sinus walls, findings that were consistent with the clinical diagnosis of a neurofibroma with possible malignant transformation. However, light microscopic, immunohistochemical, and ultrastructural examination of tissue from an incisional biopsy specimen were diagnostic of meningioma. This case illustrates that the clinicopathologic differential diagnosis of an enlarging mass in patient with neurofibromatosis should include sporadic, unrelated neoplasms as well as tumors known to be associated with the syndrome. 相似文献
9.
Ultrastructure of sialadenoma papilliferum 总被引:1,自引:0,他引:1
Sialadenoma papilliferum is a rare tumor of salivary gland origin and has been reported in the parotid and minor salivary glands of the oral cavity. This tumor is morphologically similar to the papillary syringoadenoma of the sweat gland. We report the clinical and morphologic features of five cases and review the literature. Ultrastructural examination of case 1 revealed the predominant cell type to be an oncocytic cell. These cells contained numerous mitochondria, exhibited parallel filaments within the cell cytoplasm, and were attached by desmosomes. The neoplastic cells appear to exhibit characteristic features of various cell types of the salivary gland duct apparatus. 相似文献
10.
C F Brummitt K B Crossley M Falken D W Stickle R T Lally B F Woolfrey 《American journal of clinical pathology》1988,89(2):238-242
An elderly woman with Streptococcus pneumoniae meningitis relatively resistant (minimum inhibitory concentration, [MIC] = 0.12 micrograms/mL) to penicillin is reported. The occurrence of penicillin-resistant pneumococcal infections is reviewed and management discussed. Because of the importance of recognition of resistant pneumococci, a state-wide clinical laboratory survey was conducted to determine the accuracy of susceptibility testing for this isolate. Of 111 laboratories completing the survey, only 26 performed the 1-microgram oxacillin disk test as recommended by the National Committee for Laboratory Standards (NCCLS). When laboratories were analyzed according to hospital size, the proficiency in performing the proper susceptibility testing was 55% (6 of 11) for hospitals with more than 400 beds versus 3% (2 of 58) for hospitals with fewer than 100 beds (P less than 0.0001 by Fisher's exact test). This contrasts with reported surveys by the College of American Pathologists (CAP), and reasons for this are explored. Guidelines for laboratory testing of S. pneumoniae are reviewed, and additional study of clinical proficiency with attention to laboratory size is recommended. 相似文献