The Ulster medical journal最新文献

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Orthopaedic Surgery in World War II: Military and Medical Role of Northern Ireland. 第二次世界大战中的矫形外科：北爱尔兰的军事和医疗作用

The Ulster medical journal

Pub Date : 2016-09-01

John Hedley-Whyte, Debra R Milamed

引用次数: 0

An autograph letter of Dr. Renĕ Laennec. reni Laennec博士的签名信。

The Ulster medical journal

Pub Date : 2016-03-01 DOI: 10.14744/ANATOLJCARDIOL.2016

J. Logan

ImagesFig. 1Fig. 2

引用次数: 0

DISEASES OF THE DIGESTIVE SYSTEM 消化系统疾病

The Ulster medical journal

Pub Date : 2016-01-22 DOI: 10.1002/9781119264910.CH22

Linda E. Schmeltzer, G. Norsworthy

引用次数: 0

Tenckhoff Peritoneal Dialysis Catheter Insertion in a Northern Ireland District General Hospital. 北爱尔兰一家地区综合医院的 Tenckhoff 腹膜透析导管插入术。

The Ulster medical journal

Pub Date : 2015-10-01

Donna McCartan, Ronan Gray, John Harty, Geoff Blake

Introduction: Chronic kidney disease (CKD) affects approximately 5% of the population. Based on 2014 data, peritoneal dialysis (PD) is underutilised in Northern Ireland with a prevalence of only 11% in patients requiring renal replacement therapy (RRT). Recent National Institute of Clinical Excellence (NICE) guidelines aim to increase the rate of PD utilisation to 39% amongst patients requiring RRT. In order to implement these guidelines, nephrologists must have access to a reliable, effective PD catheter insertion service. The aim of this study was to assess the outcomes of PD catheter insertions and incident rates of PD use in a single centre in anticipation of a potential increased uptake.

Methods: A retrospective analysis was conducted of all patients who underwent PD catheter insertion between April 2003 and October 2011. Case notes were reviewed for demographic information, complications, need for re-intervention, and primary catheter patency at 12 months. The UK Renal Registry annual reports were also reviewed for data on annual uptake of PD in our institution.

Results: Fifty-four patients underwent PD catheter insertion between 2005 and 2011; 61% were male with a median age of 58 (range 21-82) years. Early complications (≤30 days) included bowel perforation (n=1) and wound infection (n=2). During this study period 17 (31%) patients required manipulation or reinsertion for catheter obstruction/migration. The primary catheter patency at 12 months was 76%. The average uptake of PD as the first treatment modality (incident use) was 21.3% compared to a Northern Ireland (NI) average of 12.4%.

Conclusion: Complication rates were comparable to the International Society of Peritoneal Dialysis (ISPD) guidelines in this case series and PD uptake was higher than the NI average. Therefore, local provision of an expert surgical PD catheter insertion service may potentially facilitate an increased uptake of this modality amongst RRT patients but further research is warranted.

引言慢性肾病（CKD）影响着约 5% 的人口。根据 2014 年的数据，北爱尔兰腹膜透析 (PD) 的使用率较低，在需要接受肾脏替代治疗 (RRT) 的患者中仅占 11%。国家临床优化研究所（NICE）最近的指导方针旨在将腹膜透析在需要 RRT 的患者中的使用率提高到 39%。为了实施这些指南，肾科医生必须获得可靠、有效的 PD 导管插入服务。本研究的目的是评估一个中心的腹膜透析导管插入结果和腹膜透析的使用率，以应对可能增加的使用率：方法：对 2003 年 4 月至 2011 年 10 月期间所有接受 PD 导管插入手术的患者进行了回顾性分析。对病例记录中的人口统计学信息、并发症、再次介入治疗的需求以及 12 个月时的主要导管通畅情况进行了审查。此外，还查阅了英国肾脏登记处的年度报告，以了解本机构每年使用PD的数据：2005年至2011年间，54名患者接受了PD导管插入术；61%为男性，中位年龄为58岁（21-82岁）。早期并发症（≤30 天）包括肠穿孔（1 例）和伤口感染（2 例）。在本研究期间，17 名患者（31%）因导管阻塞/移位而需要操作或重新插入导管。12 个月时的主要导管通畅率为 76%。PD作为第一种治疗方式的平均使用率为21.3%，而北爱尔兰（NI）的平均使用率为12.4%：结论：在该系列病例中，并发症发生率与国际腹膜透析学会（ISPD）指南相当，腹膜透析的使用率高于北爱尔兰的平均水平。因此，在当地提供腹膜透析导管插入手术专家服务可能会促进 RRT 患者更多地采用这种方式，但仍需进一步研究。

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引用次数: 0

Battle of the Atlantic: Military and Medical Role of Northern Ireland (After Pearl Harbor). 大西洋之战：北爱尔兰的军事和医疗作用（珍珠港事件后）》。

The Ulster medical journal

Pub Date : 2015-10-01

John Hedley-Whyte, Debra R Milamed

引用次数: 0

Dementia 痴呆

The Ulster medical journal

Pub Date : 2015-05-01 DOI: 10.1002/0470842350

E. Cunningham, B. McGuinness, B. Herron, A. Passmore

Dementia is a clinical diagnosis requiring new functional dependence on the basis of progressive cognitive decline. It is estimated that 1.3% of the entire UK population, or 7.1% of those aged 65 or over, have dementia. Applying these to 2013 population estimates gives an estimated number of 19,765 people living with dementia in Northern Ireland. The clinical syndrome of dementia can be due to a variety of underlying pathophysiological processes. The most common of these is Alzheimer's disease (50-75%) followed by vascular dementia (20%), dementia with Lewy bodies (5%) and frontotemporal lobar dementia (5%). The clinical symptoms and pathophysiological processes of these diseases overlap significantly. Biomarkers to aid diagnosis and prognosis are emerging. Acetylcholinesterase inhibitors and memantine are the only medications currently licensed for the treatment of dementia. The nature of symptoms mean people with dementia are more dependent and vulnerable, both socially and in terms of physical and mental health, presenting evolving challenges to society and to our healthcare systems.

痴呆是一种临床诊断，需要在进行性认知衰退的基础上新的功能依赖。据估计，英国总人口的1.3%，或65岁及以上老年人的7.1%患有痴呆症。将这些数据应用到2013年的人口估计数中，北爱尔兰估计有19,765人患有痴呆症。痴呆的临床综合征可能是由于多种潜在的病理生理过程。其中最常见的是阿尔茨海默病(50-75%)，其次是血管性痴呆(20%)、路易体痴呆(5%)和额颞叶痴呆(5%)。这些疾病的临床症状和病理生理过程有明显的重叠。帮助诊断和预后的生物标志物正在出现。乙酰胆碱酯酶抑制剂和美金刚是目前唯一获准用于治疗痴呆的药物。症状的性质意味着痴呆症患者在社会和身心健康方面都更加依赖和脆弱，给社会和我们的医疗保健系统带来了不断变化的挑战。

引用次数: 0

Interstitial Lung Disease 肺间质性疾病

The Ulster medical journal

Pub Date : 2015-02-01 DOI: 10.1201/b15603-27

Yoshinobu Saito, A. Gemma

In interstitial lung disease, inflammation and/or scarring (fibrosis) occurs in the interstitium of the lung. The interstitium of the lung refers to the microscopic area within the walls of the alveoli (air sacs) between the membrane of the air sac and the membrane of the surrounding blood vessels. Like the leaves on a tree, the alveoli arise from the tiniest bronchioles (airways). There are hundreds of millions of alveoli in a lung: more than a couple would fit on the period at the end of this sentence. Each alveolus (individual air sac) is surrounded by a network of tiny blood vessels (capillaries) — like mesh encircling the alveolus. The air sac and blood vessels together are called a respiratory unit. This is where the exchange of oxygen and carbon dioxide takes place. Normally, oxygen passes easily from inside the air sac, through its membrane, across the interstitium and through the membrane of the blood vessel in which red blood cells are lined up and ready to be loaded with oxygen like empty train cars waiting to be filled with cargo. In interstitial lung disease, inflammation, scarring or fibrosis thickens the interstitium, making the lung thick and restricted from filling to their normal capacity and preventing oxygen from passing freely into the bloodstream.

在间质性肺病中，炎症和/或瘢痕(纤维化)发生在肺间质。肺间质是指肺泡(气囊)壁内介于气囊膜和周围血管膜之间的微观区域。就像树上的叶子一样，肺泡是由最小的细支气管(气道)产生的。肺里有数以亿计的肺泡:在这句话末尾的句号上可以容纳不止一对肺泡。每个肺泡(单个气囊)都被细小的血管(毛细血管)网络包围着，毛细血管像网状物一样环绕着肺泡。气囊和血管一起称为呼吸单位。这是氧气和二氧化碳交换发生的地方。正常情况下，氧气很容易地从气囊内部穿过膜，穿过间质，穿过血管膜，其中红细胞排列整齐，随时准备装载氧气，就像等待装满货物的空火车车厢一样。在间质性肺病中，炎症、瘢痕或纤维化使间质增厚，使肺变厚，不能正常充盈，阻止氧气自由进入血液。

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引用次数: 0

A 10-YEAR REVIEW OF UNSTABLE THORACOLUMBAR SPINAL FRACTURES FROM NORTHERN IRELAND: THE ASSOCIATED INJURIES 北爱尔兰不稳定胸腰椎骨折的10年回顾:相关损伤

The Ulster medical journal

Pub Date : 2014-11-01 DOI: 10.1016/J.IJSU.2014.08.009

S. Thomson, H. Julian, G. McLorinan, E. Verzin, A. Hamilton, N. Eames

引用次数: 0

Hibernia 爱尔兰

The Ulster medical journal

Pub Date : 2014-01-01 DOI: 10.1163/2214-8647_dnp_e512730

B. Kelly

引用次数: 2

Acute Headache 严重的头痛

The Ulster medical journal

Pub Date : 2014-01-01 DOI: 10.1201/b13465-15

R. Forbes

Acute Headache accounts for about 3% of acute medical unit admissions and up to 8% of Emergency Room attendances. What follows is an approach to this problem based on the characteristics of the presenting headache type. For each type of acute headache there is a fairly well defined differential diagnosis. If you appreciate the clinical features that are associated with different headache disorders, then you are more likely to identify the correct cause and manage your patient effectively. You should also appreciate that nonneurological disorders, such as carbon monoxide poisoning can present with acute headache.

急性头痛约占急性医疗单位入院人数的3%，占急诊室就诊人数的8%。下面是一种基于呈现头痛类型特征的解决方法。对于每种类型的急性头痛都有一个相当明确的鉴别诊断。如果你了解与不同头痛疾病相关的临床特征，那么你就更有可能确定正确的原因并有效地治疗你的病人。你也应该认识到，非神经系统疾病，如一氧化碳中毒，可能会出现急性头痛。

引用次数: 0

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