Therapeutic

治疗性
  • 文章类型: Case Reports
    简介软组织结核是一种罕见的肺外结核,并且在pop窝中的孤立定位尤其例外。不典型的临床表现可导致诊断延迟和严重的并发症。病例报告我们报告了一名17岁的患者,该患者被诊断患有pop窝结核。他表现为与腹股沟同侧淋巴结相关的右pop窝疼痛性炎症肿胀,无膝关节积液。标准的胸部和膝盖X光片是正常的,而核磁共振显示有一个8厘米的血管化良好,pop窝中部分液化的物质,与半膜肌和腓肠肌内侧肌接触发展,与没有滑膜积液或增厚的the淋巴结有关。微生物测试没有分离出任何细菌。活检后的组织学检查做出了诊断,显示了由上皮样细胞包围的干酪样肉芽肿。患者接受抗结核治疗9个月。随访2年,观察到肿胀的临床和放射学消退,无复发。结论任何软组织脓肿都应引起结核病的怀疑。尤其是在流行国家。应强调组织病理学检查的重要性,以在没有有利于主要定位的迹象的情况下建立诊断。
    Introduction Tuberculosis of the soft tissues is a rare form of extra pulmonary tuberculosis, and isolated localization in the popliteal fossa is particularly exceptional. Atypical clinical presentation can lead to delayed diagnosis and serious complications. Case report We report the case of a 17-year-old patient who was diagnosed with tuberculosis of the popliteal fossa. He presented with a painful inflammatory swelling of the right popliteal fossa associated with a homolateral inguinal lymph node, without knee joint effusion. Standard chest and knee X-rays were normal, while MRI showed an 8 cm well vascularized, partly liquefied mass in the popliteal fossa, developed in contact with the semimembranosus and medial gastrocnemius muscles, associated with a popliteal lymph node without synovial effusion or thickening. Microbiological tests did not isolate any germs. The diagnosis was made on histological examination after biopsy, which revealed a caseous granuloma surrounded by epithelioid cells. The patient was treated with anti-tuberculosis therapy for 9 months. The clinical and radiological regression of the swelling was observed without recurrence at 2 years of follow-up. Conclusion Any soft tissue abscess should raise suspicion of tuberculosis, especially in endemic countries. The importance of histopathological examination should be emphasized to establish the diagnosis in the absence of signs in favor of a primary localization.
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  • 文章类型: Journal Article
    治疗依从性(TC)是指患者对医生的处方和建议的依从性。癌症患者通常表现出不令人满意的TC。我们研究的目的是评估癌症患者的TC水平,并确定依从性差的预测因素。作者于2023年3月在肿瘤学中心进行了一项横断面研究,绝大多数医疗活动都是在日间医院进行的。使用问卷或调查测量TC。分析各种参数以确定不良治疗依从性的预测因素。作者的研究包括175名癌症患者,平均年龄为55岁。研究表明,85%的患者表现出良好的依从性(GC),如CI[8.500±0.075]所示,表示患者坚持他们的用药时间表。相反,15%的人表现出较差的合规性(PC),如置信区间[0.825±0.750]所示。通过将遵守规定的用药时机的患者视为良好依从性(GC),而未遵守的患者视为不良依从性(PC)来评估依从性状态。对我们研究结果的分析表明,不良的治疗依从性与较低的社会经济和教育水平有关。因此,重要的是利用所有可用资源来提高治疗依从性。导致依从性差的大多数因素可以通过患者与其支持网络之间的有效协调来缓解。
    Therapeutic compliance (TC) refers to the patient\'s compliance with the prescriptions and recommendations of a doctor. Patients with cancer often exhibit unsatisfactory TC. The objective of our study was to assess TC levels in cancer patients and identify predictors of poor compliance. The authors conducted a cross-sectional study in March 2023 at the oncology centre, where the vast majority of medical activity is performed in the day hospital. TC was measured using a questionnaire or survey. Various parameters were analyzed to identify predictive factors of poor therapeutic compliance. The authors\' study included 175 cancer patients with a mean age of 55 years. The study revealed that 85% exhibited good compliance (GC) as indicated by the CI [8.500 ± 0.075], signifying patients who consistently adhered to their medication schedule. Conversely, 15% demonstrated poor compliance (PC), as indicated by the confidence interval [0.825 ± 0.750]. Compliance status was assessed by considering patients who adhered to the prescribed medication timing as good compliance (GC) and those who did not adhere as poor compliance (PC). The analysis of our study results indicated that poor therapeutic compliance was associated with low socio-economic and educational levels. Therefore, it is important to utilize all available resources to improve therapeutic compliance. The majority of factors contributing to poor compliance can be mitigated through effective coordination between the patient and their support network.
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  • 文章类型: Journal Article
    背景:支架移植物放置通常用于治疗腋窝动脉(AA)干的假性动脉瘤(PSA),以维持外周血管的通畅。很少报道与AA主干破裂相关的PSA的线圈栓塞。
    方法:一名54岁女性右肩肿胀。她12年前患有右肱骨近端骨折。对比增强计算机断层扫描(CECT)和随后的血管造影显示,右远端AA。从近端到右AA有侧支流向肱动脉。为了保持肱动脉的侧支流动,来自远端AA的流入动脉的选择性栓塞用水凝胶涂层线圈进行。栓塞后动脉造影显示没有流入PSA,但是侧支流向了我们保留的肱动脉.栓塞后的过程是顺利的。患者在栓塞后第4天恢复了右臂和手的温暖。在栓塞后第9天重复CECT,证实她的右桡动脉有血流。
    结论:如果可以保留AA主干,则应使用支架移植物,如果AA主干被破坏但络脉保留,则应考虑对PSA进行线圈栓塞。
    BACKGROUND: Stent-graft placement is generally used to treat pseudoaneurysm (PSA) of the axillary artery (AA) trunk to maintain the patency of peripheral vessels. Coil embolization of a PSA associated with a disrupted AA trunk has rarely been reported.
    METHODS: A 54-year-old woman presented with swelling of her right shoulder. She had had a right proximal humeral fracture 12 years earlier. Contrast-enhanced computed tomography (CECT) and subsequent angiograms revealed a giant PSA at the disrupted, distal right AA. There were collateral flows to the brachial artery from the proximal to the right AA. To preserve collateral flows to the brachial artery, selective embolization of the inflow artery that derived from the distal AA was performed with hydrogel-coated coils. The post-embolization arteriogram showed no flow into the PSA, but collateral flows to the brachial artery we preserved. The post-embolization course was uneventful. The patient regained warmth in her right arm and hand on post-embolization day 4. Repeat CECT on post-embolization day 9 confirmed blood-flow to her right radial artery.
    CONCLUSIONS: While a stent-graft should be used if the AA trunk can be preserved, coil embolization should be considered for PSA if the AA trunk is disrupted but collaterals are preserved.
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  • 文章类型: Journal Article
    该研究的目的是评估慢性血液透析患者的药物处方质量。
    作者对摩洛哥东部乌吉达市两个血液透析中心的慢性血液透析患者进行了一项前瞻性研究,在2020年。作者根据产品特征确定了该人群中规定的药物,在适应症方面,禁忌症,剂量和药物相互作用。我们的数据采用SPSS版本27软件进行分析。
    每位患者平均服用药物数量为8.15±6。93%的患者接受了贫血治疗。89%和72%的患者接受了磷酸钙疾病和高血压的治疗,分别。在77.6%的病例中,这些药物是口服的。根据Vidal的说法,大多数处方符合好处方的标准,在81.54%的病例中,与18.46%的患者至少有一个不合规的处方。另一方面,6.15%的患者至少有一种不可取的组合。在我们的患者中没有发现禁忌关联。
    接受血液透析的患者比肾功能正常的患者发生副作用和药物相互作用的风险更高。鉴于该人群的药代动力学研究很少,肾脏病学家参考他们自己的经验来有效地治疗他的病人。慢性血液透析患者的治疗教育和定期监测可以改善临床预后,生活质量和降低护理成本。
    UNASSIGNED: The aim of the study was to assess the quality of drugs prescriptions in chronic haemodialysis patients.
    UNASSIGNED: The authors conducted a prospective study in chronic haemodialysis patients of two haemodialysis centres in the city of Oujda eastern Morocco, during the year of 2020. The authors identified the drugs prescribed in this population with regards to the product characteristics, in terms of indications, contraindications, dosage and drug interactions. Our data were analyzed by SPSS version 27 software.
    UNASSIGNED: The mean number of drugs taken per patient was 8.15±6. Ninety-three percent of patients received treatment for anaemia. Phosphocalcic disorders and hypertension were treated in 89% and 72% of patients, respectively. In 77.6% of the cases, these drugs were taken orally. According to Vidal, the majority of prescriptions met the criteria of good prescription, in 81.54% of the cases, versus 18.46% of the patients with at least one of non-compliant prescription. On the other hand, 6.15% of the patients had at least one inadvisable combination. No contraindicated association was noted in our patients.
    UNASSIGNED: Patients undergoing haemodialysis have a higher risk of developing side effects and drug interactions than patients with normal kidney function. Given the paucity of pharmacokinetic studies in this population, nephrologists refer to their own experience to treat his patients effectively.Therapeutic education and regular monitoring of chronic haemodialysis patients can improve clinical outcomes, quality of life and reduce the cost of care.
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  • 文章类型: Case Reports
    小肠静脉曲张破裂出血是消化道出血的罕见原因,临床表现从无症状的偶然发现到危及生命的疾病。由于病变的定位和手术的困难,小肠出血的诊断和治疗具有挑战性。经动脉栓塞(TAE)是治疗异位静脉曲张的一种安全而直接的方法。另一方面,关于小肠静脉曲张出血患者TAE结局的本地研究有限.本文报道了诊断为小肠静脉曲张破裂出血并接受TAE治疗的患者。
    Small bowel variceal bleeding is a rare cause of gastrointestinal hemorrhage, with clinical manifestations ranging from asymptomatic incidental findings to life-threatening conditions. The diagnosis and management of small bowel bleeding are challenging because of the localization of the lesion and the difficulty of the procedure. Trans-arterial embolization (TAE) is a secure and straightforward method for treating ectopic varices. On the other hand, there have been limited local studies on the outcomes of TAE for patients with small bowel variceal hemorrhage. This paper reports patients diagnosed with small bowel variceal bleeding and treated with TAE.
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  • 文章类型: Review
    十二指肠静脉曲张是门脉高压症的罕见并发症。尽管十二指肠静脉曲张出血很少见,这是一种危及生命的疾病,死亡率很高。十二指肠静脉曲张出血的非手术方法包括内镜下绑带结扎术,内镜硬化治疗,经颈静脉肝内门体分流术,逆行经静脉闭塞。另一方面,尚未确定针对这种罕见疾病的最佳治疗策略。一名38岁的男性,有酒精性肝硬化病史,并出现呕血。急诊食管胃十二指肠镜检查(EGD)显示,十二指肠第二部分有多个静脉曲张,并相应地进行了塞式辅助逆行经静脉闭塞术(PARTO)。手术后胃肠道出血得到解决。11周后进行的EGD随访显示先前观察到的十二指肠静脉曲张完全消失。PARTO可能被认为是治疗十二指肠静脉曲张破裂出血的可行选择。
    Duodenal varices are uncommon complications of portal hypertension. Although duodenal variceal bleeding is infrequent, it is a life-threatening condition with a high mortality rate. Non-surgical methods for duodenal variceal bleeding include endoscopic band ligation, endoscopic sclerotherapy, transjugular intrahepatic portosystemic shunt, and retrograde transvenous obliteration. On the other hand, an optimal treatment strategy for this rare condition has not been established. A 38-year-old male with a history of alcoholic liver cirrhosis presented with hematemesis. An emergency esophagogastroduodenoscopy (EGD) revealed large, multiple varices in the second portion of the duodenum, and plug-assisted retrograde transvenous obliteration (PARTO) was performed accordingly. Gastrointestinal bleeding was resolved after the procedure. Follow-up EGD conducted after 11 weeks revealed complete obliteration of the previously observed duodenal varices. PARTO may be considered a viable option for treating duodenal variceal bleeding.
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  • 文章类型: Case Reports
    小鱼间动脉动脉瘤很少见,表现为真正的动脉瘤或假性动脉瘤。传统上,手术修复一直是治疗这些动脉瘤的主要手段,仅报告了孤立的血管内治疗病例。在这项研究中,我们描述了两例成功通过线圈栓塞治疗的鱼际-鱼际动脉瘤,伴随着一个简短的文献综述。我们的发现表明,血管内治疗是这些罕见动脉瘤的可行治疗选择。
    Thenar-hypothenar arterial aneurysms are rare, presenting as either true aneurysms or pseudoaneurysms. Traditionally, surgical repair has been the mainstay of treatment for these aneurysms, with only isolated cases of endovascular management reported. In this study, we describe two cases of thenar-hypothenar aneurysms successfully managed with coil embolization, accompanied by a brief literature review. Our findings suggest that endovascular management is a feasible treatment option for these rare aneurysms.
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  • 文章类型: Journal Article
    It has been documented that patients with mental or physical disabilities can benefit from being placed within the setting of a natural environment. Consequently, the concept of creating spaces that can enhance health preservation or patient recovery, while also augmenting environmental and aesthetic value, has merged as a contemporary discourse. Green areas around hospitals can offer a great opportunity to incorporate healing gardens to benefit their patients and not only. The aim of this paper is to propose a design for a sensory-therapeutic garden based on key principles derived from selected academic literature, focusing on the application of these principles in a healthcare setting in Cluj-Napoca, Romania. The design was informed also by onsite data collection and analysis, and it aims to create a healing landscape that addresses the needs of patients, healthcare providers, and visitors. This study seeks to augment the discourse in the field by demonstrating the practical application of key therapeutic garden design principles in a specific context and how these principles impacted the design process.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    基于社区的大麻种植模式,分布,和消费-如大麻俱乐部-已经在欧洲各地记录在案,北美,南美洲,自1990年代以来的新西兰。在大多数情况下,这些模式有在现有法律法规之外运作的历史。使大麻合法化的司法管辖区以相反的方式接近基于社区的模式(消除与规范)。加拿大将大麻合法化导致了更严格的执法和协调一致的努力,以关闭这些模式,尽管有据可查的健康和社会效益。本文介绍了维多利亚大麻买家俱乐部(VCBC)及其消费空间的案例研究。我们对VCBC成员进行了一项调查,以探索四个领域:人口统计,大麻消费,访问和使用盒子,以及由于COVID-19而暂时关闭的影响。根据调查数据(n=104),我们生成了描述性统计数据,并确定了三个概念性途径.大多数受访者年龄在40岁及以上,被确定为白人(欧洲血统)的男性和女性。大多数人报告的收入为40,000美元或以下,住房状况阻止了他们吸烟。近75%的样本每天消耗大麻主要用于治疗目的,而且是为了混合娱乐,社会,精神,传统的治疗目的。吸烟是首选的消费方式。受访者每天或每周访问TheBox。使用TheBox的原因和好处分为三类:公共卫生,减少危害,和健康观点。概念上,我们发现盒子作为一个治疗空间,为吸烟者提供了一个急需的消费空间。我们还确定需要解开安全概念。总的来说,该调查加强了对加拿大基于社区的模式和大麻消费空间采取公平知情方法的必要性。
    Community-based models of cannabis cultivation, distribution, and consumption-such as cannabis clubs-have been documented across Europe, North America, South America, and New Zealand since the 1990s. For the most part, these models have a history of operating outside existing legislation and regulations. Jurisdictions that have legalized cannabis have approached community-based models in opposite ways (eliminate vs. regulate). Canada legalizing cannabis has resulted in more stringent enforcement and concerted efforts to close these models despite documented health and social benefits. This paper presents a case study of the Victoria Cannabis Buyers Club (VCBC) and its consumption space-The Box. We conducted a survey of VCBC members to explore four domains: demographics, cannabis consumption, access to and use of The Box, and the impact of its temporary closure due to COVID-19. From the survey data (n = 104), descriptive statistics were generated and three conceptual avenues were identified. The majority of respondents were 40 years old and older and identified as White (European descent) cisgendered men and women. The majority reported an income of $40,000 or less and a housing status that prevented them from smoking. Close to 75% of our sample consumed cannabis multidaily for therapeutic purposes primarily, but also for a mix of recreation, social, spiritual, and traditional healing purposes. Smoking was the preferred mode of consumption. Respondents accessed The Box daily or weekly. Reasons and benefits for using The Box fell into three categories: public health, harm reduction, and wellness perspectives. Conceptually, we found that The Box acted as a therapeutic space and offered a much-needed consumption space for smokers. We also identified a need to unpack the concept of safety. Overall, the survey reinforces the need for an equity-informed approach to community-based models and cannabis consumption spaces in Canada.
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