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1.
认知功能障碍在肌萎缩侧索硬化(ALS)患者中是普遍存在的,ALS伴认知功能障碍常提示预后不良。近年来对ALS患者认知功能障碍的研究取得了一定的进展,本文对ALS伴认知功能障碍的临床特点、生物标志物、遗传学特征和最新治疗进展进行综述,以期为ALS伴认知功能障碍的临床诊疗提供新思路。 相似文献
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《Archivos de bronconeumología》2022,58(3):246-254
We have updated recommendations on 12 controversial topics that were published in the 2013 National Consensus on the diagnosis, risk stratification and treatment of patients with pulmonary embolism (PE). A comprehensive review of the literature was performed for each topic, and each recommendation was evaluated in two teleconferences. For diagnosis, we recommend against using the Pulmonary Embolism Rule Out Criteria (PERC) rule as the only test to rule out PE, and we recommend using a D-dimer cutoff adjusted to age to rule out PE. We suggest using computed tomography pulmonary angiogram as the imaging test of choice for the majority of patients with suspected PE. We recommend using direct oral anticoagulants (over vitamin K antagonists) for the vast majority of patients with acute PE, and we suggest using anticoagulation for patients with isolated subsegmental PE. We recommend against inserting an inferior cava filter for the majority of patients with PE, and we recommend using full-dose systemic thrombolytic therapy for PE patients requiring reperfusion. The decision to stop anticoagulants at 3 months or to treat indefinitely mainly depends on the presence (or absence) and type of risk factor for venous thromboembolism, and we recommend against thrombophilia testing to decide duration of anticoagulation. Finally, we suggest against extensive screening for occult cancer in patients with PE. 相似文献
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Heather L. Brown 《Journal of emergency nursing》2021,47(2):321-325
The coronavirus 2019 pandemic has affected almost every aspect of health care delivery in the United States, and the emergency medicine system has been hit particularly hard while dealing with this public health crisis. In an unprecedented time in our history, medical systems and clinicians have been asked to be creative, flexible, and innovative, all while continuing to uphold the important standards in the US health care system. To continue providing quality services to patients during this extraordinary time, care providers, organizations, administrators, and insurers have needed to alter longstanding models and procedures to respond to the dynamics of a pandemic. The Emergency Medicine Treatment and Active Labor Act of 1986, or EMTALA, is 1 example of where these alterations have allowed health care facilities and clinicians to continue their work of caring for patients while protecting both the patients and the clinicians themselves from infectious exposures at the same time. 相似文献
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中国抗癌协会神经内分泌肿瘤专业委员会 《中国癌症杂志》2022,32(6):545-579
神经内分泌肿瘤(neuroendocrine neoplasm,NEN)是一类起源于肽能神经元和神经内分泌细胞,具有神经内分泌分化并表达神经内分泌标志物的少见肿瘤,可发生于全身各处,以肺及胃肠胰NEN(gastroenteropancreatic neuroendocrine neoplasm, GEP-NEN)最常见。国内外研究数据均提示,NEN的发病率在不断上升。美国流行病学调查结果显示,与其他类型肿瘤相比,NEN的发病率上升趋势更为显著。中国抗癌协会神经内分泌肿瘤专委会在现有循证医学证据基础上,结合已有国内外指南和共识,制订了首版中国抗癌协会神经内分泌肿瘤诊治指南,为临床工作者提供参考。 相似文献
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Ehsan Zarei Elmira Madarshahian Adeleh Nikkhah Soheila Khodakarim 《Journal of tissue viability》2019,28(2):70-74
Background and objective
Pressure ulcer (PU) is one of the important and frequent complications of hospitalization, associated with high treatment costs. The present study was conducted to determine the incidence of PU and its direct treatment costs for patients in intensive care unit (ICU) in Iran.Material and methods
In this retrospective study, medical records of 643 discharged patients from ICU of two selected hospitals were examined. The demographic and clinical data of all patients and data of resources and services usage for patients with PU were extracted through their records. Data analysis was done using logistic regression tests in SPSS 22 software. The cost of PU treatment was calculated for each grade of ulcer.Results
The findings showed that 8.9% of patients developed PU during their stay in ICU. Muscular paralysis (OR?=?5.1), length of stay in ICU (OR?=?4.0), diabetes (OR?=?3.5) age (OR?=?2.9), smoking (OR?=?2.1) and trauma (OR?=?1.4) were the most important risk factors of PU. The average cost of PU treatment varied from USD 12 for grade I PU to USD 66?834 for grade IV PUs. The total treatment costs for all studied patients with PU was estimated at USD 519?991.Conclusion
The cost of PU treatment is significant. Since the preventive measures are more cost-effective than therapeutic measures, therefore, effective preventive interventions are recommended. 相似文献8.
目的:对应用低分子肝素钙与奥扎格雷联合对患有脑血栓疾病的患者实施治疗的临床效果进行研究。方法整群选择在该院2012年12月—2014年12月就诊的患有脑血栓疾病的患者86例,随机分为对照组和治疗组,每组43例。采用奥扎格雷对对照组患者实施治疗;采用低分子肝素钙与奥扎格雷联合对治疗组患者实施治疗。对比神经功能缺损评分在药物治疗前后的变化幅度、脑神经功能恢复正常时间和脑血栓药物治疗计划实施总时间、脑血栓疾病药物治疗效果、用药期间的不良反应人数。结果治疗组患者神经功能缺损评分在药物治疗前后的变化幅度明显大于对照组;脑神经功能恢复正常时间(9.66±2.41)d和脑血栓药物治疗计划实施总时间(13.28±2.14)d明显短于对照组(13.62±3.47)、(17.39±3.20)d;脑血栓疾病药物治疗效果(总有效率90.6%)明显优于对照组(总有效率69.8%);用药期间的不良反应人数(1例)明显少于对照组(8例)。结论应用低分子肝素钙与奥扎格雷联合对患有脑血栓疾病的患者实施治疗的临床效果非常明显。 相似文献
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