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1.
《Neuromodulation》2021,24(8):1422-1428
ObjectivesA recent approach to treatment of cluster headaches (CH) employs a microstimulator device for on-demand neuromodulation of the sphenopalatine ganglion (SPG) during an acute CH attack. A precise anatomical localization of the SPG within the pterygopalatine fossa (PPF) is optimal in order to position the SPG electrode array. This study aims to investigate a novel approach for SPG localization using computed tomography angiographic studies (CTA).Materials and MethodsTwo independent observers identified the location of the SPG on 54 computed tomography angiographic studies (CTA) and measured its position relative to the vidian canal (VC). The qualitative confidence of identification, morphology, position within the PPF and its relation to vascular structures were also recorded.ResultsThe SPG was detectable in 88% of cases with a variable position. The most frequent positions were superior (56%) and lateral (99%) relative to the VC with a mean (±SD) craniocaudal distance of 0.34 mm (±1.38) and a mean mediolateral distance of 3.04 mm (±1.2). However, in a considerable proportion of cases, the SPG was identified inferiorly to the VC (33%). Interobserver and intraobserver agreement for SPG location were moderate and strong respectively.ConclusionsSince localization of SPG on CTAs is feasible and reproducible, it has future clinical potential to aid placement, optimal positioning and individualized programming of the electrode array. 相似文献
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3.
《Primary Care Diabetes》2022,16(3):417-421
AimsClinical inertia behaviour affects family physicians managing chronic disease such as diabetes. Literature addressing clinical inertia in the management of hypoglycemia is scarce. The objectives of this study were to create a measurement for physician clinical inertia in managing hypoglycemia (ClinInert_InHypoDM), and to determine physicians’ characteristics associated with clinical inertia.MethodsThe study was a secondary analysis of data provided by family physicians from the InHypo-DM Study, applying exploratory factor analysis. Principal axis factoring with an Oblimin rotation was employed to detect underlying factors associated with physician behaviors. Multiple linear regression was used to determine association between the ClinInert_InHypoDM scores and physician characteristics.ResultsFactor analysis identified a statistically sound 12-item one-factor scale for clinical inertia behavior. No statistically significant differences in clinical inertia score for the studied independent variables were found.ConclusionsThis study provides a scale for assessing clinical inertia in the management of hypoglycemia. Further testing this scale in other family physician populations will provide deeper understanding about the characteristics and factors that influence clinical inertia. The knowledge derived from better understanding clinical inertia in primary care has potential to improve outcomes for patients with diabetes. 相似文献
4.
《Vaccine》2020,38(39):6141-6152
Influenza vaccination is considered the most valuable means to prevent and control seasonal influenza infections, which causes various clinical symptoms, ranging from mild cough and fever to even death. Among various influenza vaccine types, the inactivated subunit type is known to provide improved safety with reduced reactogenicity. However, there are some drawbacks associated with inactivated subunit type vaccines, with the main ones being its low immunogenicity and the induction of Th2-biased immune responses. In this study, we investigated the role of a single-stranded RNA (ssRNA) derived from the intergenic region in the internal ribosome entry site of the Cricket paralysis virus as an adjuvant rather than the universal vaccine for a seasonal inactivated subunit influenza vaccine. The ssRNA adjuvant stimulated not only well-balanced cellular (indicated by IgG2a, IFN-γ, IL-2, and TNF-α) and humoral (indicated by IgG1 and IL-4) immune responses but also a mucosal immune response (indicated by IgA), a key protector against respiratory virus infections. It also increases the HI titer, the surrogate marker of influenza vaccine efficacy. Furthermore, ssRNA adjuvant confers cross-protective immune responses against heterologous influenza virus infection while promoting enhanced viral clearance. Moreover, ssRNA adjuvant increases the number of memory CD4+ and CD8+ T cells, which can be expected to induce long-term immune responses. Therefore, this ssRNA-adjuvanted seasonal inactivated subunit influenza vaccine might be the best influenza vaccine generating robust humoral and cellular immune responses and conferring cross-protective and long-term immunity. 相似文献
5.
Abstract Migraine without aura is typically considered a female condition. The purpose of this study was to determine if there have
been any changes in the female-to-male ratio of the disease over time. We included in the study all patients with migraine
without aura (n=3457) referred to the Parma University Headache Centre between 1976 and 1995. They were divided into subgroups with respect
to gender and year-range of onset of migraine (before 1960, in the 1960s, in the 1970s, in the 1980s, and between 1990 and
1995). Gender ratio ranged from 3.6:1 (in patients with onset before 1960) to 2.8:1 (in patients with onset in the 1980s),
with no statistically significant changes during the observation period. 相似文献
6.
应用秩和比法研究门诊人数增长与门诊医疗质量因子的关系 总被引:3,自引:0,他引:3
目的研究医院门诊人数增长与门诊医疗质量因子的关系,找出影响门诊人数增长的主要门诊医疗质量因子。方法利用秩和比法对实例进行分析。结果影响门诊人数增长的门诊质量因子,首先是高中级职称比(χ2=32.43,P<0.05),其次是副高以上职称的坐诊工时比(χ2=31.91,P<0.05),再次是新技术项目或重大改革(χ2=28.54,P>0.05)。结论研究医院门诊人数增长与门诊医疗质量因子的关系时,秩和比法有应用推广的价值。 相似文献
7.
8.
基于人文理念的护理质量例会实践与体会 总被引:1,自引:0,他引:1
张育 《中国卫生质量管理》2010,17(5):13-14
建立以人文理念为核心的护理质量分析例会制度,每月召开门诊护士长、护士组长、护士代表例会,分析、讲评门诊护理服务中存在的问题,并提出改进方案,持续改进门诊护理服务质量。 相似文献
9.
Marcela Hernández Hoyos Piotr Orłowski Ewa Piątkowska-Janko Piotr Bogorodzki Maciej Orkisz 《International journal of computer assisted radiology and surgery》2006,1(1):51-61
The accuracy of 2D phase contrast (PC) magnetic resonance angiography (MRA) depends on the alignment between the vessels and
the imaging plane. PC MRA imaging of blood flow is challenging when the flow in several vessels is to be evaluated with one
acquisition. For this purpose, semi-automatic determination of the plane most perpendicular to several vessels is proposed
based on centerlines extracted from 3D MRA. Arterial centerlines are extracted from 3D MRA based on iterative estimation-prediction,
multi-scale analysis of image moments, and a second-order shape model. The optimal plane is determined by minimizing misalignment
between its normal vector and the centerlines’ tangent vectors. The method was evaluated on a phantom and on 35 patients,
by seeking the optimal plane for cerebral blood flow quantification simultaneously in internal carotids and vertebral arteries.
In the phantom, difference of orientation and of height between known and calculated planes was 1.2° and 2.5 mm, respectively.
In the patients, all but one centerline were correctly extracted and the misalignment of the plane was within 12° per artery.
Semi-automatic centerline extraction simplifies and automates determination of the plane orthogonal to one vessel, thereby
permitting automatic simultaneous minimization of the misalignment with several vessels in PC MRA. 相似文献
10.
医院综合效益评价案例分析 总被引:2,自引:0,他引:2
西南地区医院综合效益评价课题组 《中国医院管理》1994,14(2):32-35
运用层次分析法建立了医院综合效益评价指标体系,开发了医院综合效益九型评价图,用于显著评价结果。在此基础上进行了3个案例的评价分析。论述了通过对西南地区27所医院综合效益4年多的追踪分析所发现的共性问题,并提出了相应的管理对策。 相似文献