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missed diagnosis of early gastric cancer or high-grade intraepithelial neoplasia

World Journal of Gastroenterology 2013年第13期19卷 2092-2096页

作者： Wei Ren Jin Yu Zhi-Mei Zhang Yuan-Kun Song Yi-Hui Li Lei Wang Department of Gastroenterology Xin Qiao HospitalThe Third Military Medical University

AIM: To investigate the causes of missed diagnosis of early gastric cancer (EGC) or high-grade intraepithelial neoplasia (HGIN) in Chongqing, China. METHODS: The present study summarizes 103 cases of EGC/HGIN detected by esophagogastroduodenos-copy (EGD) and pathological analysis from January 2010 to December 2011. Dimethyl silicone oil was administrated orally 15 min before the EGD procedures. The stomach was cleaned by repeated washing with saline when the gastroscope entered the stomach cavity. Suspected EGC lesions were subject to conventional biopsy sampling and pathological examinations. The correlation between lesion locations, endoscopic morphology of cancerous sites, training level of the examiners, pathological biopsies, and missed diagnosis was analyzed. RESULTS: Twenty-three cases were missed among the 103 cases (22.23%) of EGC/HGIN. The rate of missed EGC in the gastroesophageal junction (8/19, 42.1%) was significantly higher than at other sites (15/84, 17.86%) (χ2 = 5.253, P = 0.022). In contrast, the rate of missed EGC in the lower stomach body (2/14, 14.29%) was lower than at other sites (21/89,23.6%), but there were no significant differences (χ2 = 0.289, P = 0.591). The rate of missed EGC in the gastric antrum (5/33, 15.15%) was lower than at other sites (18/70, 25.71%), but there were no significant differences (χ2 = 1.443, P = 0.230). Endoscopists from less prestigious hospitals were more prone to not diagnosing EGC than those from more prestigious hospitals (χ2 = 4.261, P = 0.039). When the number of biopsies was missed diagnosis was higher (20/23, 89.96%) than for when there were > 4 biopsies (3/23, 13.04%) (P missed diagnosis in patients with 1-3 biopsy specimens (χ2 = 0.141, P = 0.932). CONCLUSION: Endoscopists should have a clear understanding of the anatomical characteristics of the esophagus/stomach, and endoscopic identification of early lesions inc

关键词： missed diagnosis Early gastric cancer High-grade intraepithelial neoplasia Endoscopic diagnosis Biopsies

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missed Prevention of Mother-to-Child Transmission of HIV (PMTCT) Visits and Associated Programmatic Predictors: A Pilot Study

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Advances in Infectious Diseases 2017年第4期7卷 107-117页

作者： Augustine Ndaimani Inam Chitsike Clara Haruzivishe Babill Stray-Pedersen Department of Nursing Science University of Zimbabwe College of Health Sciences Harare Zimbabwe Department of Paediatrics University of Zimbabwe College of Health Sciences Harare Zimbabwe Division of Women Rikshospitalet Institute of Clinical Medicine University of Oslo Oslo Norway

missed Prevention of Mother-to-Child Transmission of HIV (PMTCT) visits have contributed to the delayed achievement of elimination of mother-to-child transmission of HIV. missed visits promote attrition from prevention of mother-to-child transmission of HIV program and antiretroviral drug resistance. The purpose of the study was to determine the prevalence of missed PMTCT visits and its associated predictors. A descriptive cross sectional survey was carried out at a District Hospital in Goromonzi, Zimbabwe. Fifty-three women completed closed-ended questionnaires pertaining to PMTCT visits and exposure to PMTCT activities. A total of 24.5% missed at least one scheduled PMTCT visit. Statistically significant predictors of not missing a PMTCT visit were satisfaction with family support (β = −0.73, p = 0.029) and level of satisfaction with PMTCT services (β = −0.00076;p = 0.04). The number of days by which scheduled visits were missed were inversely correlated with visit number (β = −2.99, p = 0.04). Enhanced family support and quality improvement to improve patient satisfaction may reduce missed visits. Availing women with a more active role in PMTCT may also reduce the prevalence of missed visits.

关键词： missed Visits Option B Plus Pilot Study PMTCT (Prevention of Mother-to-Child Transmission of HIV) Predictors

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missed Opportunities for Prevention of Mother-to-Child Transmission of HIV (PMTCT) in Ibadan, Southwest Nigeria

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World Journal of AIDS 2014年第3期4卷 356-364页

作者： Babatunde O. Ogunbosi Regina E. Oladokun Olutosin Awolude Biobele J. Brown Olubukola A. Adeshina Modupe Kuti Babafemi Taiwo Baiba Berzins Demetrious N. Kyriacou Ellen G. Chadwick Kikelomo Osinusi Isaac F. Adewole Robert L. Murphy Department of Paediatrics College of Medicine University of Ibadan Ibadan Nigeria Department of Paediatrics University College Hospital Ibadan Nigeria Department of Obstetrics and Gynecology College of Medicine University of Ibadan Ibadan Nigeria Department of Obstetrics and Gynecology University College Hospital Ibadan Nigeria Department of Chemical Pathology College of Medicine University of Ibadan Ibadan Nigeria Department of Internal Medicine Feinberg School of Medicine Northwestern University Chicago USA Center for Global Health Institute for Public Health and Medicine Feinberg School of Medicine Northwestern University Chicago USA Department of Emergency Medicine Feinberg School of Medicine Northwestern University Chicago USA Department of Pediatrics Feinberg School of Medicine Northwestern University Chicago USA

Background: Nigeria has the largest paediatric HIV-infected population in the world. missed opportunities for prevention of mother-to-child transmission of HIV (PMTCT) compromise efforts at eliminating new pediatric HIV infections. Methods: Six hundred children, aged missed opportunities for PMTCT. Step 1: utilization of a health facility for antenatal care and delivery;Step 2: maternal HIV status determination during pregnancy;Step 3: provision of antiretroviral medication to HIV-infected mother and baby;and Step 4: avoidance of mixed feeding in HIV-exposed children. The rates of missed opportunities for PMTCT services at different steps in the PMTCT cascade, perinatal transmission rates, and associated factors were reported. Results: There were 599 mothers and 600 children (one set of twins), 60 (10%) were HIV infected and 56 (93.3%) of these were adjudged perinatally infected. Of 78 HIV-infected women, 7 (9.0%) accessed all interventions in the PMTCT cascade and 71 (91.0%) had missed opportunities for PMTCT. missed opportunities for PMTCT occurred 42.9% in cascade Step 1, 64.2% in Step 2, 52.6% in step 3 and 73.7% in Step 4. All mother-baby pairs who accessed complete PMTCT interventions received care at a teaching hospital. Among infants with perinatal HIV infection, 53 (94.6%) were born to mothers who had missed opportunities for PMTCT. Most women with missed opportunities attended antenatal care outside the teaching hospital setting and belonged to low socioeconomic status. Conclusion: It is imperative to expand PMTCT access to women who receive antenatal care outside the teaching hospitals and to those of low socioeconomic status.

关键词： HIV Perinatal Prevention PMTCT missed Opportunities

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missed acute pulmonary embolism and sudden death: A case report

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Journal of Acute Disease 2019年第3期8卷 123-126页

作者： Yasser Mohammed Hassanain Elsayed Critical Care Unit Fraskour Central HospitalEgypt

Rationale: Pulmonary embolism is a severe cardiovascular disease. Acute pulmonary embolism is an extremely common and potentially the serious pattern of venous thromboembolic disease. Unfortunately, missed diagnosis of pulmonary embolism is lethal and common because of its non-specific symptoms and signs. Patient concerns: A 42-year-old male patient presented with acute chest pain that was treated as gastroesophageal reflux disease. Diagnosis: Suspected acute pulmonary embolism. Interventions: O2inhalation, urgent electrocardiography, and cardiopulmonary resuscitation. Outcomes: Deterioration and sudden cardiac death. Lessons: Physicians should pay much attention to the symptoms and signs of pulmonary embolism to reduce the rate of missed diagnosis.

关键词： missed acute pulmonary embolism Sudden death Ignorance Diagnosis Pulmonary embolism

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Student’s Perception of missed Care: Focus Group Results

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Open Journal of Nursing 2017年第7期7卷 850-874页

作者： Mary Kalfoss Diakonova University College Oslo Norway

Background: With the inflation of economic constraints on health care and demand to increase care quality, there is an increasing need to develop a clear understanding of what actions by health professionals are perceived as threatening quality care. Objective: To explore graduate nursing and pastoral care student’s perceptions of missed care in Norway. Research design: A qualitative study was employed with the formation of six focus groups. Data was analyzed via a thematic content of the discussions. Participants and research context: Thirty-one students attending a University College in Oslo participated. Findings: Five major themes and thirty subthemes were identified. Major themes included labor constraints, organizational contraints, professional constraints, communication constaints and emotional strain. Discussion: Findings of this study resonate with other research as well as with studies on missed nursing care. Findings also lend support to the definition of missed nursing care actions as required care that is omitted, either in part or whole, or delayed. Conclusion: The findings from this study extend understanding of what barriers health professionals perceive as inhibiting them from offering quality care. The focus groups provided a valuable flora for discussion regarding what participants perceived as missed.

关键词： missed Nursing Care Suboptimal Care Noncaring Focus g Groups Nursing Pastoral Counseling

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How I Nearly missed Her

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大学英语 1999年第6期 2-3页

作者：明廷雄

ＩｆＩｈａｄｎｔｃｈａｎｇｅｄｍｙａｇｅｎｔ，ｉｆＩｈａｄｎｔｔａｋｅｎｔｈｅｐａｒｔ，ｉｆ．．．ＢｙＧｅｎｅＷｉｌｄｅｒＩｎｅｖｅｒｕｓｅｄｔｏｂｅｌｉｅｖｅｉｎｆａｔｅ．Ｉｔｈｏｕｇｈｔｙｏｕｍａｄｅｙｏｕｒ... 详细信息

ＩｆＩｈａｄｎｔｃｈａｎｇｅｄｍｙａｇｅｎｔ，ｉｆＩｈａｄｎｔｔａｋｅｎｔｈｅｐａｒｔ，ｉｆ．．．ＢｙＧｅｎｅＷｉｌｄｅｒＩｎｅｖｅｒｕｓｅｄｔｏｂｅｌｉｅｖｅｉｎｆａｔｅ．Ｉｔｈｏｕｇｈｔｙｏｕｍａｄｅｙｏｕｒｏｗｎｌｉｆｅ，ａｎｄｉｔｗａｓａ...

关键词：电影剧本 Her How missed Nearly

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Application of “Swanson’s Middle Range Caring Theory” in Sweden after miscarriage

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International Journal of Clinical Medicine 2011年第2期2卷 102-109页

作者： Caroline Jansson Annsofie Adolfsson Division of Reproductive and Perinatal Health Care Department of Women"s Health Karolinska Institutet School of Life Sciences University of Skovde

Objective: The aim of this study was to apply Swanson’s Middle Range Caring Theory to the follow-up visit with a midwife for Swedish women who have suffered early miscarriage or received care for late missed miscarriage in preg-nancy week 18-20. Methods: Twenty-five tape recorded interviews with women four weeks after their early miscarriages and thirteen tape recorded semi-structured interviews with midwives and nurses who had the experience of caring for women who have been diagnosed with a missed miscarriage during a routine ultrasound scan. The interviews were transcribed verbatim and interpreted deductively from the text using the theory. Results: Each woman described her personal experience of miscarriage in the relative terms of a human experience. The midwives and nurses described their experiences with women who received care for missed miscarriage. The interviews included information about the treatment provided by the caregivers during the period afterward of the diagnosis. The caregiver attitude was formed from Swanson’s caring categories: “Maintaining belief”, “knowing”, “being with”, “doing for”, “enabling”. Conclusions: Swanson’s Middle Range Caring Theory as applied to the caregiver includes being emotionally present, giving support with respect for the woman’s dignity, being competent, meeting each woman’s own individual needs. Given the proper care after a miscarriage every woman has the power within herself to improve their wellbeing.

关键词： Swanson’s Middle Range Caring Theory Miscarriage missed Miscarriage Qualitative Method

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APPLICATION OF BAYESIAN APPROACH TO ESTIMATE AVERAGE LEVEL SPACING

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中国核科技报告 1991年第S1期 62-69页

作者： Huang Zhongfu (GUANGXI UNIVERSITY)Zhao Zhixiang (CHINESE NUCLEAR DATA CENTER, IAE)

A methof to estimate average level spacing from a set of resolved reso-nance parameters by using Bayesian approach is *** the information given in the distributions of both levels spacing and neutron width,the level missing in measured sample can be corrected more precisely so that better esti-mate for average level spacing can be obtained in this *** calculation of s-wave resonance has been done and comparison with other work was car-ried out.

关键词： spacing corrected precisely neutron missing Bayesian nuclei simply resolved missed

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Kidney and Urinary Tract

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China Medical Abstracts(Internal Medicine) 2014年第4期31卷 220-221页

2014461 Meta-analysis of the efficacy of two-compartment peritoneal dialysis fluid with low glucose degradation products in peritoneal dialysis *** Fuli(罗富里),et *** Nephrol,Jiangxi Prov People’s Hosp,Nanchang *** J Nephrol2014;30(9):*** To study the efficacy of the two-compartment peritoneal dialysis fluid with low glucose degradation products in peritoneal dialysis(PD)*** Pubmed,EBMASE,Cochrane Library,Wanfang,VIP,CNKI,CBM and other databases were searched,at the same time the information form relevant

关键词： dialysis peritoneal Nanchang Kidney 富里 compartment Jiangxi Cochrane missed multivariate

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Clinical study in diagnosis of placental implantation abnormality with transabdominal Doppler ultrasound

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Discussion of Clinical Cases 2017年第1期4卷 5-8页

作者： Fanwen Bu Shuna Shen Third Affiliated Hospital of Inner Mongolia Medical University BaotouChina

Objective: To evaluate the ultrasonographic charateristics and the diagnostic value in placental implantation abnormality (PIA) with transabdominal Doppler ultrasound, and improve the rate of diagnosis accuracy in the prenatal and postnatal of PIA with transabdominal Doppler ultrasound, for early diagnosis and treatment, to avoid hysterectomy caused by fatal bleeding. Methods: There were 61 cases complicated with PIA by operation and pathologically confirmed in our hospital. 33 cases were prenatal PIA, and 28 cases were postnatal PIA. The sonographic characteristics of PIA were summarized, the sensitivity and false negative rate of transabdominal Doppler ultrasound were analyzed with the results of surgical and pathological diagnosis. Results: In the images of prenatal PIA, the incidence of abundant blood flow signals in muscular layer of the placenta was the highest, which could reached 85.7%, followed by placenta 'vortex' and placenta previa;placental remnants were major sonographic performance in postnatal PIA, the incidence rate was 100%, followed by abundant blood flow signals in muscular layer of the placenta and disappeared boundary between myometrium and placenta. 14 cases could be diagnosed as prenatal PIA accurately by transabdominal Doppler ultrasound, the sensitivity was 42.4%, and the false negative rate was 57.6%. 21 cases could be diagnosed as postnatal PIA accurately by transabdominal Doppler ultrasound, the sensitivity was 75.0%, and the false negative rate was 25.0%. Conclusions: The specificity was low in prenatal PIA by transabdominal Doppler ultrasound, but the false negative rate was high. If necessary, the diagnostic accuracy could be improved combined with MRI. The specificity was much higher in postnatal PIA, and the false negative rate was low. The ultrasonography of PIA has some certain characteristics, we should strengthen the consciousness of the diagnosis in PIA, especially in the prenatal PIA, and improve the auxiliary diagnosis.

关键词： Transabdominal Doppler ultrasound Placental implantation abnormality Ultrasonography Plancental invasion missed diagnosis

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