Clinical and morphological analysis of 143 cases of "pulmonary peripheral shades" in patients treated in the department of thoracic surgery of Medical Academy in Lublin

In spite of a constant development of various diagnostic methods, in many cases of "peripheral shades" the exploratory opening of the chest appears to be the only way leading to a correct diagnosis. In this study, 143 patients were examined. These patients were referred to the Thoracic Surgery Department because of peripheral shades in the lung areas observed, often accidentally; on regular checkup X rays. Our paper assessed the usefulness of endoscopic examinations in diagnosing the changes situated peripherally in the lungs. 83.2% of those shades were recognized as neoplasms on the basis of histopathological examinations. Moreover , we evaluated the concordance of histopathological diagnosis before and after the operation.     

Medical errors in surgery

Researchers at the Institute of Medicine have reported a staggering number of medical errors, that is, adverse effects as a result of treatment, in healthcare in America. This article argues against a no-faults systems view as a corrective for these events and calls us instead to trust the motivations of providers and the peer review process to bring about the needed cultural revolution. It sees healthcare as an honorable profession rather than an off-the-shelf commodity, and calls on providers to be courageous leaders who make safety their priority.     

外科深部真菌感染的病原学分析

目的分析外科住院患者合并真菌感染状况。方法分离的真菌用API 20C AUX真菌鉴定条,用ATB FUNGUS-2进行药敏试验。结果真菌的种类分布中第1位是白色念珠菌占53%,第2位是热带念珠菌占20%,第3位是光滑念珠菌占14%,第4位是近平滑念珠菌占4%,第5位是其余念珠菌占2%;真菌在外科各区分布中,外科ICU占42%,移植外科占25%;真菌在各类标本分布中,痰占43%,尿液占13%,粪便占10%,引流液占9%,血液占7%;真菌对药物5-氟胞嘧啶、两性霉素B、氟康唑、伊曲康唑的药物敏感性分别是93%、98.9%、90.8%、59.8%。结论外科真菌感染集中在重症病区(ICU),分离的致病真菌主要是白色念珠菌、热带念珠菌、光滑念珠菌,真菌对两性霉素B敏感性最高。     

Removal of the uterus and ovaries and the opinion of women postoperatively]

Forty five women undergoing total hysterectomy were interviewed after surgery. The investigators were interested in their opinion on the outcome of performed surgery. One year later, a questionnaire was mailed to these women which included questions about their physical status, psychologic well-being and everyday activities. Fear against cancer, physical health and psychologic well-being as well as sexual activity persisted for one year or longer following surgery. The number of questioned women reporting worsening of sexual relations with their partners and emotional disturbances increased one year after hysterectomy. Moreover, a significant increase in the number of women who had informed their relatives about surgery was also noted.     

Medical patients aged 65 and over admitted to an accident and emergency department.

A study of 100 consecutive emergency medical admissions to Oldchurch Hospital was made to establish if the mode of referral--either by the general practitioner or self referral--influenced the presentation and severity of illness and the eventual outcome. Of the 94 cases analysed, 55 were self referred and 39 were sent in by their general practitioners. No significant differences were found between the two groups of patients, which suggests that the patient (or the patient''s family or companion) is as discriminating as the general practitioner in deciding when emergency referral to hospital is necessary.