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Dinesh Singhal Nandini Vasdev Arvinder Soin Subash Gupta Samiran Nundy 《Indian journal of gastroenterology》2006,25(4):206-207
It is difficult to distinguish between carcinoid tumors of the pancreatic head and periampullary region and carcinomas preoperatively. Between 1996 and 2002, 125 consecutive pancreaticoduodenectomies done by us for periampullary tumors (14 carcinoids, 111 carcinomas) were analyzed. Patients with carcinoid tumors had significantly younger mean age (48 vs. 54 years), longer history (32 vs. 8 weeks), lower serum total bilirubin levels (1.4 vs. 6.3 mg/dL) and on CT scan, had larger, well-localized tumors (5 cm vs. 2 cm). Their postoperative course was better with no mortality or major morbidity, whereas after resection for carcinoma 7 (6.3%) patients died and 30 (27%) had major postoperative complications. Thus, a tumor of this region in a young patient with indolent history, low bilirubin level and with CT scan depicting a large expansile lesion suggests a carcinoid. Such tumors may be safely resected with low postoperative morbidity and mortality and good long-term prognosis. 相似文献
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This paper describes the systems of nursing operating at a major cancer centre in the United Kingdom. The review was undertaken over a period of 8 weeks and 11 wards were included. The systems being implemented were primary nursing, team nursing and patient allocation. Methods of enquiry included questionnaires, non-participative observation and interviews. The results of the review found the nursing systems to be at various stages of implementation, and that in reality, not all wards were operating the system they said they were. A pragmatic mixture of team nursing and primary nursing as described by Hegyvary (1982) was being practised on some of the wards. The report makes recommendations for change, and concludes by discussing the future implications for cancer nursing at the centre. 相似文献
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AR Jones BSC AJP Sandison FRCS WJ Owen MS FRCS 《International journal of clinical practice》1997,51(5):294-295
Pre-clerking of all patients undergoing elective general surgical operations was introduced at our hospital in an attempt to reduce an unacceptably high operation cancellation rate. A prospective audit has been performed on the effect of this policy on the cancellation rate. Before the introduction of pre-clerking there was a marked seasonal variation in the number of patients who failed to attend for surgery, which could be explained by absence on holiday. This seasonal variation disappeared after the start of pre-clerking clinics, but there has been no reduction in the number of cancellations for medical reasons. 相似文献
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