Pub Date : 2021-01-01DOI: 10.35248/2329-9096.21.S4.005
Shin J Oh
Amifampridines have been known to be effective as symptomatic treatment of Lambert-Eaton myasthenic syndrome since 1983. Food Drug Administration (FDA) approved amifampridines, the most studied safe and effective drugs in the neuromuscular diseases, are available for the general use for symptomatic treatment of LEMS, 60 years after the first description of LEMS and 40 years after the first trial of 3,4-DAP in LEMS.
{"title":"Amifampridines (3,4 Diaminopyridine and 3,4 Diaminopyridine Phosphate): Drugs of Choice for Lambert-Eaton Myasthenic Syndrome","authors":"Shin J Oh","doi":"10.35248/2329-9096.21.S4.005","DOIUrl":"https://doi.org/10.35248/2329-9096.21.S4.005","url":null,"abstract":"Amifampridines have been known to be effective as symptomatic treatment of Lambert-Eaton myasthenic syndrome since 1983. Food Drug Administration (FDA) approved amifampridines, the most studied safe and effective drugs in the neuromuscular diseases, are available for the general use for symptomatic treatment of LEMS, 60 years after the first description of LEMS and 40 years after the first trial of 3,4-DAP in LEMS.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80255821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.35248/2329-9096.21.S4.002
Sarah E. Playford, L. Hackett, George Ac Murell
Supraspinatus tendinopathy is a common cause of shoulder pain and tendon degeneration in individuals who participate in repetitive overhead activities, such as tennis players or tradespeople. Early diagnosis and treatment of tendinopathies is necessary to prevent chronic sequelae and tendon rupture, which is especially important for groups such as professional athletes and manual workers for avoidance of prolonged downtime.
{"title":"Application of Shear Wave Elastography in Diagnosing Tendinopathies","authors":"Sarah E. Playford, L. Hackett, George Ac Murell","doi":"10.35248/2329-9096.21.S4.002","DOIUrl":"https://doi.org/10.35248/2329-9096.21.S4.002","url":null,"abstract":"Supraspinatus tendinopathy is a common cause of shoulder pain and tendon degeneration in individuals who participate in repetitive overhead activities, such as tennis players or tradespeople. Early diagnosis and treatment of tendinopathies is necessary to prevent chronic sequelae and tendon rupture, which is especially important for groups such as professional athletes and manual workers for avoidance of prolonged downtime.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84452964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Object: To explore the effect of web-based real-time interactive intervention teaching model on self-efficacy of Gestational Diabetes Mellitus (GDM) patients. Method: Based on the hospital’s antenatal check-up archives from June 2018 to January 2019, patients diagnosed with GDM in the second trimester were randomly divided into the control group (100 cases) and the experimental group (121 cases). Patients in the control group received routine care following the diabetes mellitus one-day outpatient guidance, while patients in the experimental group received social media real-time interactive teaching intervention based on routine care, and accepted a nursing intervention scheme based on knowledge-attitude-practice mode. The knowledge of GDM, self-efficacy and self-management behavior indicators were compared between the two groups. Results: After the intervention, the self-efficacy scores, the blood glucose monitoring times and the blood glucose compliance rates of the experimental group were significantly higher than those of the control group (P P = 0.072). Conclusion: Web-based real-time interactive intervention teaching model can effectively improve the self-efficacy of GDM patients and promote the formation of healthy behaviors.
目的:探讨基于网络的实时互动干预教学模式对妊娠糖尿病(GDM)患者自我效能感的影响。方法:根据该院2018年6月至2019年1月的产前检查档案，将诊断为妊娠中期GDM的患者随机分为对照组(100例)和实验组(121例)。对照组患者在糖尿病一日门诊指导下进行常规护理，实验组患者在常规护理基础上进行社交媒体实时互动教学干预，并采用基于知识-态度-实践模式的护理干预方案。比较两组患者GDM知识、自我效能感、自我管理行为指标。结果:干预后，实验组患者自我效能感评分、血糖监测次数及血糖依从率均显著高于对照组(P P = 0.072)。结论:基于网络的实时互动干预教学模式能有效提高GDM患者的自我效能感，促进健康行为的形成。
{"title":"Study on the Effect of Web-Based Real-Time Interactive Intervention Teaching Model on Self-Efficacy of Gestational Diabetes Mellitus Patients","authors":"Yu Yang, Qiuying Lin, Pingping Quan, Yanmei Wen, Xuyao Li, Jufang Lin","doi":"10.4236/ijcm.2020.1112058","DOIUrl":"https://doi.org/10.4236/ijcm.2020.1112058","url":null,"abstract":"Object: To explore the effect of web-based real-time interactive intervention teaching model on self-efficacy of Gestational Diabetes Mellitus (GDM) patients. Method: Based on the hospital’s antenatal check-up archives from June 2018 to January 2019, patients diagnosed with GDM in the second trimester were randomly divided into the control group (100 cases) and the experimental group (121 cases). Patients in the control group received routine care following the diabetes mellitus one-day outpatient guidance, while patients in the experimental group received social media real-time interactive teaching intervention based on routine care, and accepted a nursing intervention scheme based on knowledge-attitude-practice mode. The knowledge of GDM, self-efficacy and self-management behavior indicators were compared between the two groups. Results: After the intervention, the self-efficacy scores, the blood glucose monitoring times and the blood glucose compliance rates of the experimental group were significantly higher than those of the control group (P P = 0.072). Conclusion: Web-based real-time interactive intervention teaching model can effectively improve the self-efficacy of GDM patients and promote the formation of healthy behaviors.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89881616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-28DOI: 10.4236/ijcm.2020.119042
C. Ker, Hong-Yi Tong, Ming-Yuen Yang, I. Tseng, Der-Ming Chang, hong-Yaw Chen, Bowei Wang, C. Ko, C. Chao, Yu-Fu Chen
Introduction: Hepatocellular carcinoma (HCC) has a poor prognosis and is ranked in the top 2 leading causes of death in Taiwan. The clinical features which affect survival rate should be noticed for alarming. We tried to study the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) for the predictor of prognosis of HCC. Patients and Methods: A total of 525 patients with HCC were undergone surgical or non-surgical treatment registered in Cancer Registry Center of our hospital. The clinical features included patient’s basic profiles, and neutrophil, lymphocyte and platelet count in the peripheral blood at the time of diagnosis. The ratio of neutrophil/lymphocyte and platelate/lymphocyte was measured and their survival rates were analyzed based on their ratio scales. Results: Three scales of NLR and PLR were ≤1.62, 1.63 - 2.57, ≥2.58 and ≤224, 225 - 253, ≥254 respectively. Either higher NLR ≥ 2.58 or higher PLR ≥ 254 was found mostly in the male and TMN stage III and IV with a significant difference (P < 0.01). The 5-year survival rates of NLR ≤ 1.62, 1.63 - 2.57, ≥2.58 were 33.9%, 33.7%, and 16.7% respectively (P < 0.001). The mean survival times were 34.1 ± 1.4, 29.3 ± 8.1, and 14.2 ± 2.1 months for the scales of PLR ≤ 224, 225 - 253, and ≥ 254 respectively. The 5-year survival rates were 25.5%, 36.4%, and 7.7% for the groups of the PLR ≤ 224, 225 - 253, and ≥254 respectively (p < 0.001). Conclusion: Neutrophil, lymphocyte and platelet are players in cancer growth and have a potential role as predictors of survival in our HCC patients. Therefore, we should pay more attention to the higher NLR or PLR which will result in a poorer prognosis in our patients.
{"title":"Role of Pre-Operative of Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratio in Prognosis of Hepatocellular Carcinoma","authors":"C. Ker, Hong-Yi Tong, Ming-Yuen Yang, I. Tseng, Der-Ming Chang, hong-Yaw Chen, Bowei Wang, C. Ko, C. Chao, Yu-Fu Chen","doi":"10.4236/ijcm.2020.119042","DOIUrl":"https://doi.org/10.4236/ijcm.2020.119042","url":null,"abstract":"Introduction: Hepatocellular carcinoma (HCC) has a poor prognosis and is ranked in the top 2 leading causes of death in Taiwan. The clinical features which affect survival rate should be noticed for alarming. We tried to study the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) for the predictor of prognosis of HCC. Patients and Methods: A total of 525 patients with HCC were undergone surgical or non-surgical treatment registered in Cancer Registry Center of our hospital. The clinical features included patient’s basic profiles, and neutrophil, lymphocyte and platelet count in the peripheral blood at the time of diagnosis. The ratio of neutrophil/lymphocyte and platelate/lymphocyte was measured and their survival rates were analyzed based on their ratio scales. Results: Three scales of NLR and PLR were ≤1.62, 1.63 - 2.57, ≥2.58 and ≤224, 225 - 253, ≥254 respectively. Either higher NLR ≥ 2.58 or higher PLR ≥ 254 was found mostly in the male and TMN stage III and IV with a significant difference (P < 0.01). The 5-year survival rates of NLR ≤ 1.62, 1.63 - 2.57, ≥2.58 were 33.9%, 33.7%, and 16.7% respectively (P < 0.001). The mean survival times were 34.1 ± 1.4, 29.3 ± 8.1, and 14.2 ± 2.1 months for the scales of PLR ≤ 224, 225 - 253, and ≥ 254 respectively. The 5-year survival rates were 25.5%, 36.4%, and 7.7% for the groups of the PLR ≤ 224, 225 - 253, and ≥254 respectively (p < 0.001). Conclusion: Neutrophil, lymphocyte and platelet are players in cancer growth and have a potential role as predictors of survival in our HCC patients. Therefore, we should pay more attention to the higher NLR or PLR which will result in a poorer prognosis in our patients.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87577071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-28DOI: 10.4236/ijcm.2020.119045
J. Sato, S. Iwasa, Y. Honma, A. Takashima, N. Okita, Ken Kato, T. Hamaguchi, Y. Yamada, N. Boku
Purpose: Several studies have shown that fluoropyrimidine plus oxaliplatin (SOX) is non-inferior to fluoropyrimidine plus cisplatin as first-line chemotherapy for advanced gastric cancer. We investigated retrospectively the choice of second-line regimen, along with the proportion and feasibility of paclitaxel-containing regimen, in the subsequent treatment of patients with advanced gastric cancer treated with SOX as first-line chemotherapy. Materials and Methods: We retrospectively analyzed the impact of oxaliplatin-induced neuropathy on both the choice of subsequent regimens and feasibility of subsequent chemotherapy with paclitaxel, focusing on patients with advanced gastric cancer who received S-1 plus oxaliplatin as first-line chemotherapy. Results: Twenty-seven from a total of 31 patients enrolled into the phase 2 and phase 3 study assessing S-1 plus oxaliplatin were analyzed (4 patients were deemed ineligible). Among 24 patients that had received second-line treatment, paclitaxel was not selected in 2 patients due to oxaliplatin-induced neuropathy. Paclitaxel was selected as second-line chemotherapy in 16 patients, as third-line chemotherapy in 6 patients and fourth-line chemotherapy in one patient. Severity of sensory neuropathy was grade 0/1/2/3 in 11/10/2/0 patients, respectively, immediately before treatment with paclitaxel, while the worst toxicity profile during paclitaxel treatment was grade 0/1/2/3 in 7/13/1/2 patients, respectively. Although there were no patients requiring dose reductions of paclitaxel due to neuropathy, 2 patients discontinued paclitaxel use due to grade 3 sensory neuropathy after 4 or 8 administrations of paclitaxel. Conclusion: Oxaliplatin-induced neuropathy during first-line chemotherapy may affect the choice and feasibility of subsequent chemotherapy with paclitaxel in advanced gastric cancer patients.
{"title":"Impact of Oxaliplatin-Induced Neuropathy on Subsequent Paclitaxel for Advanced Gastric Cancer","authors":"J. Sato, S. Iwasa, Y. Honma, A. Takashima, N. Okita, Ken Kato, T. Hamaguchi, Y. Yamada, N. Boku","doi":"10.4236/ijcm.2020.119045","DOIUrl":"https://doi.org/10.4236/ijcm.2020.119045","url":null,"abstract":"Purpose: Several studies have shown that fluoropyrimidine plus oxaliplatin (SOX) is non-inferior to fluoropyrimidine plus cisplatin as first-line chemotherapy for advanced gastric cancer. We investigated retrospectively the choice of second-line regimen, along with the proportion and feasibility of paclitaxel-containing regimen, in the subsequent treatment of patients with advanced gastric cancer treated with SOX as first-line chemotherapy. Materials and Methods: We retrospectively analyzed the impact of oxaliplatin-induced neuropathy on both the choice of subsequent regimens and feasibility of subsequent chemotherapy with paclitaxel, focusing on patients with advanced gastric cancer who received S-1 plus oxaliplatin as first-line chemotherapy. Results: Twenty-seven from a total of 31 patients enrolled into the phase 2 and phase 3 study assessing S-1 plus oxaliplatin were analyzed (4 patients were deemed ineligible). Among 24 patients that had received second-line treatment, paclitaxel was not selected in 2 patients due to oxaliplatin-induced neuropathy. Paclitaxel was selected as second-line chemotherapy in 16 patients, as third-line chemotherapy in 6 patients and fourth-line chemotherapy in one patient. Severity of sensory neuropathy was grade 0/1/2/3 in 11/10/2/0 patients, respectively, immediately before treatment with paclitaxel, while the worst toxicity profile during paclitaxel treatment was grade 0/1/2/3 in 7/13/1/2 patients, respectively. Although there were no patients requiring dose reductions of paclitaxel due to neuropathy, 2 patients discontinued paclitaxel use due to grade 3 sensory neuropathy after 4 or 8 administrations of paclitaxel. Conclusion: Oxaliplatin-induced neuropathy during first-line chemotherapy may affect the choice and feasibility of subsequent chemotherapy with paclitaxel in advanced gastric cancer patients.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73962981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-28DOI: 10.4236/ijcm.2020.119046
Shunling Li, S. Liang, Weihua Xue
Objectives: To explore the main points of perioperative nursing for adult congenital heart disease with severe pulmonary arterial hypertension. Methods: A retrospective study of 13 patients with congenital heart disease and severe pulmonary arterial hypertension who admitted to the perioperative period of care from January 2018 to December 2019. To prevent perioperative complications of the patients, the focus is on respiratory and circulatory system care, followed by blood coagulation monitoring, digestive system protection and psychological care. Results: All 13 patients passed the perioperative period and were discharged from ICU. Conclusion: Adult congenital heart disease with severe pulmonary arterial hypertension has high perioperative risk, respiratory and circulatory system care is the key.
{"title":"Perioperative Nursing for Adult Congenital Heart Disease with Severe Pulmonary Arterial Hypertension","authors":"Shunling Li, S. Liang, Weihua Xue","doi":"10.4236/ijcm.2020.119046","DOIUrl":"https://doi.org/10.4236/ijcm.2020.119046","url":null,"abstract":"Objectives: To explore the main points of perioperative nursing for adult congenital heart disease with severe pulmonary arterial hypertension. Methods: A retrospective study of 13 patients with congenital heart disease and severe pulmonary arterial hypertension who admitted to the perioperative period of care from January 2018 to December 2019. To prevent perioperative complications of the patients, the focus is on respiratory and circulatory system care, followed by blood coagulation monitoring, digestive system protection and psychological care. Results: All 13 patients passed the perioperative period and were discharged from ICU. Conclusion: Adult congenital heart disease with severe pulmonary arterial hypertension has high perioperative risk, respiratory and circulatory system care is the key.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81263302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-06DOI: 10.4236/ijcm.2020.118041
Shunling Li, S. Liang, Weihua Xue
Background: Septic shock is a rapidly changing and fatal syndrome that can cause comprehensive deterioration of cardiopulmonary and renal function and multiple organ failure. At the same time, septic shock has the complex clinical manifestations and hemodynamics. PiCCO can accurately monitor blood flow, physical and volume indicators, and active and effective fluid resuscitation are important measures to reduce the fatality rate of septic shock and improve the prognosis of patients. Objectives: To explore the application and nursing of PiCCO in early fluid resuscitation in patients with septic shock. Methods: This was a retrospective observational study. The observation group and the control group each had 30 cases. The observation group used PiCCO to guide fluid resuscitation; the control group used conventional methods to guide fluid resuscitation. The changes in CVP, HR, MAP, and urine volume per hour were observed in the two groups. The changes of various indicators before and after fluid resuscitation, the length of stay in ICU and the mortality rate were compared between the two groups. All the outcomes were collected from the electronic medical case system after patients’ discharge from the hospital. Results: APACHE II, CVP, HR, MAP were compared between the observation group and the control group, and the differences were statistically significant (P 0.05). The blood volume of patients in the observation group was significantly improved after fluid supplementation (P 0.05). Compared with the control group, the length of stay in ICU in the observation group was significantly shorter, and the mortality rate was also significantly reduced (P 0.05). Conclusion: PiCCO can be better used in early fluid resuscitation of patients with septic shock.
{"title":"Application and Nursing of Pulse Index Continuous Cardiac Output (PiCCO) Volume Monitoring in Early Fluid Resuscitation in Patients with Septic Shock","authors":"Shunling Li, S. Liang, Weihua Xue","doi":"10.4236/ijcm.2020.118041","DOIUrl":"https://doi.org/10.4236/ijcm.2020.118041","url":null,"abstract":"Background: Septic shock is a rapidly changing and fatal syndrome \u0000that can cause comprehensive deterioration of \u0000cardiopulmonary and renal function and multiple organ failure. At the same time, \u0000septic shock has the complex clinical manifestations and hemodynamics. PiCCO can \u0000accurately monitor blood flow, physical and volume indicators, and active \u0000and effective fluid resuscitation are important measures to reduce the fatality \u0000rate of septic shock and improve the prognosis of patients. Objectives: To \u0000explore the application and nursing of PiCCO \u0000in early fluid resuscitation in patients with septic shock. Methods: This was a retrospective observational study. The observation group and the \u0000control group each had 30 cases. The observation group used PiCCO to guide fluid \u0000resuscitation; the control group used conventional methods to guide fluid resuscitation. The changes in CVP, HR, MAP, \u0000and urine volume per hour were observed in the two groups. The changes of various \u0000indicators before and after fluid resuscitation, the length of stay in ICU and the \u0000mortality rate were compared between the two groups. All the outcomes were collected \u0000from the electronic medical case system after patients’ discharge from the hospital. Results: APACHE II, CVP, HR, MAP were compared between \u0000the observation group and the control group, and the differences were \u0000statistically significant (P 0.05). The blood volume of patients in the observation group was significantly improved after fluid supplementation (P 0.05). Compared with the control \u0000group, the length of stay in ICU in the observation group was significantly shorter, \u0000and the mortality rate was also significantly reduced (P 0.05). Conclusion: PiCCO can be better used in early fluid resuscitation \u0000of patients with septic shock.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77389173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-06DOI: 10.4236/ijcm.2020.118040
Qian Zhao, Zhang-shun Shen, Hui Guo, Jian-Guo Li
Clinical thinking have the uncertainty, by which there are not a few mistakes caused. So it is necessary to discuss how to deal with the uncertainty of clinical thinking, which originates from the uncertainty of the objective world, social world and medicine knowledge, and can be seen all over clinical activities; Critical thinking which cautious about the interpretation and prediction of scientific theory is the best practice to explore the uncertainty. The essential purpose of medicine is rescuing people, So it is necessary and scientific to take “excluding life-threatening symptoms first” as the first principle of clinical thinking, which is also the primary method to deal with the uncertainty of clinical thinking; By the limited certainty of clinical thinking, procedural thinking is conducive to building a safer health system that is “easy to do right and difficult to do wrong”.
{"title":"Uncertainty of Clinical Thinking and Patient Safety","authors":"Qian Zhao, Zhang-shun Shen, Hui Guo, Jian-Guo Li","doi":"10.4236/ijcm.2020.118040","DOIUrl":"https://doi.org/10.4236/ijcm.2020.118040","url":null,"abstract":"Clinical thinking have the uncertainty, by which there are not a few mistakes caused. So it is necessary to discuss how to deal with the uncertainty of clinical thinking, which originates from the uncertainty of the objective world, social world and medicine knowledge, and can be seen all over clinical activities; Critical thinking which cautious about the interpretation and prediction of scientific theory is the best practice to explore the uncertainty. The essential purpose of medicine is rescuing people, So it is necessary and scientific to take “excluding life-threatening symptoms first” as the first principle of clinical thinking, which is also the primary method to deal with the uncertainty of clinical thinking; By the limited certainty of clinical thinking, procedural thinking is conducive to building a safer health system that is “easy to do right and difficult to do wrong”.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86067923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-14DOI: 10.4236/ijcm.2020.117038
Marius D. Roatis, A. Georgescu
Background: Pilonidal disease is a chronic inflammatory disease of the sacrococcygeal region that mainly affects young people. Its incidence is 26 cases per 100,000 persons. Although many techniques have been described, there is no consensus on the treatment of pilonidal sinus disease (PSD). Materials and Methods: This study included 30 patients with PSD who were treated between May 2014 and September 2017. All cases underwent excision and flap reconstruction. The operative time, postoperative complications, the length of hospital stay, painless sitting and walking time, patient satisfaction and recurrence were evaluated prospectively. Results: The results of this prospective, randomized and comparative study are based on experience of a single surgical centre. All patients were followed up 18 months after discharge from the hospital. There is a difference in surgery durations (minutes) between the two groups (33.86 ± 2.89 min. in “keystone” flap vs. 41.26 ± 4.19 in the “rhombic” flap group) (p = 0.001). There were no significant differences in the length of hospital stay, painless sitting and walking time or patient satisfaction. The total complication rate was 66.6% after rhomboid flap compared with 6.6% after keystone flap. There was no flap necrosis. Conclusions: Both of these methods have shown to be successful in treatment of PSD. The KPIF is associated with the advantages of very simple design, abundant blood supply from the perforator vessels and lower rate of complication.
{"title":"Rhomboid Flap vs. Keystone Perforator Island Flap (KPIF) in the Treatment of Pilonidal Sinus Disease: Comparison of Short-Term Results","authors":"Marius D. Roatis, A. Georgescu","doi":"10.4236/ijcm.2020.117038","DOIUrl":"https://doi.org/10.4236/ijcm.2020.117038","url":null,"abstract":"Background: Pilonidal disease is a chronic inflammatory disease of the sacrococcygeal \u0000region that mainly affects young people. Its incidence is 26 cases per 100,000 persons. \u0000Although many techniques have been described, there is no consensus on the treatment \u0000of pilonidal sinus disease (PSD). Materials and Methods: This study included 30 patients with PSD who were treated between May 2014 \u0000and September 2017. All cases underwent excision and flap reconstruction. The operative \u0000time, postoperative complications, the length of hospital stay, painless sitting \u0000and walking time, patient satisfaction and recurrence were evaluated prospectively. Results: The results of this prospective, randomized and comparative study are based \u0000on experience of a single surgical centre. All patients were followed up 18 months \u0000after discharge from the hospital. There is a difference in surgery durations (minutes) \u0000between the two groups (33.86 ± 2.89 min. in “keystone” flap vs. 41.26 ± 4.19 in \u0000the “rhombic” flap group) (p = 0.001). There were no significant differences in \u0000the length of hospital stay, painless sitting and walking time or patient satisfaction. \u0000The total complication rate was 66.6% after rhomboid flap compared with 6.6% after \u0000keystone flap. There was no flap necrosis. Conclusions: Both of these methods have shown to be successful in treatment of PSD. The \u0000KPIF is associated with the advantages of very simple design, abundant blood supply \u0000from the perforator vessels and lower rate of complication.","PeriodicalId":14201,"journal":{"name":"International Journal of Physical Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85127522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-27DOI: 10.4236/ijcm.2020.115032
A. Szász, G. Szigeti, M. Szász
In some clinical applications in oncology randomized, double armed, and double-blind trials are not possible. In case of device applications, double-blinded conditions are nonrealistic, and with many times the randomization also has complications due to the high-line treatments where the reference cohort is not available; the active “arm” has mainly palliative initiative. Sometimes highly personalized therapies block the collection of the homogeneous group and limit its double-arm randomization. Our objective is to discuss the situations of the single arm evaluation and to give methods for the mining of information from this to increase the level of evidence of the measured dataset. The basic idea of the data-separation is the appropriate parameterization of the non-parametric Kaplan-Meier survival pattern by the poly-Weibull fit.
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