RÉSUMÉ
A pulmonary glue embolism is an unusual but potentially life-threatening complication following the treatment of variceal bleeding, especially in patients with large varices requiring large volumes of sclerosant. Other contributory factors include the rate of injection and ratio of the constituent components of the sclerosant [i.e. n-butylcyanoacrylate and lipiodol]. This condition may be associated with a delayed onset of respiratory compromise. Therefore, a high degree of clinical suspicion is essential in patients with unexplained cardiorespiratory decline during or following endoscopic sclerotherapy. We report a 65-year-old man who was admitted to the Hull Royal Infirmary, Hull, UK, in 2017 with haematemesis and melaena. He subsequently developed acute respiratory distress syndrome secondary to a glue embolism following emergency sclerotherapy for bleeding gastric varices. The aetiology of the embolism was likely a combination of the large size of the gastric varices and the large volume of cyanoacrylate needed. After an endoscopy, the patient underwent transjugular intrahepatic portosystemic shunting twice to control the bleeding, after which he
recovered satisfactorily
RÉSUMÉ
Objective: To understand the attitudes about mental illnesses of different types of community members. Method: A questionnaire was first developed using qualitative methods and then administered to 225 schizophrenic patients, 230 family members of schizophrenic patients, 257 community residents and 283 psychiatrists and psychiatric nurses in Beijing. Result: Patients were most optimistic and community members were most pessimistic about mental illnesses; family members tend to be optimistic, but were less positive than patients about the social contribution and treatment prospects. Mental health professionals were more negative than patients and family members but less negative than community members about social contribution, dangerousness, and need to restrict the behavior of those mentally ill. Unlike the other three groups, mental health professionals were much more likely to attribute mental illnesses to biological factors and much less to consider personal or social causes. Conclusion: To improve patient's and family members' damaged self-esteem, to enhance compliance with treatment, and to maximize patients' social rehabilitation, it is essential to rapidly institute effective measures of decreasing negative attitudes about the mentally ill in the community.
RÉSUMÉ
Objective: To improve clinical utility of the Nurses Observation Sca le for Inpatient Evaluation (NOSIE-30) in China. Methods: Based on the original scale, which only provides names and ranked scores for items, we developed clear definitions for each item and anchoring descriptions for score rating. 164 firs t-episode schizophrenic patients were evaluated with this scale every two weeks after admission. A total of 994 evaluations were completed. The collected data w ere randomly divided into two independent data sets. The number and content of t he subscales were revised based on principal component factor analysis and item analysis of the first data set. The revised scale was then evaluated and compare d with the original 7-subscale version of the instrument using the second data s et. Results: Factor analysis found that the factor structu re of the revised scal e was markedly different from that of the original instrument. Item analysis res ulted in elimination of 30 original items and redistribution of the remaining 26 items into 5 subscales. Comparison of the revised scale with the original instr ument revealed better psychometric properties for the former than the latter.Conclusion: The subscale scores of the original 7-subscale v ersion of NOSIE-30 did not reflect independent symptom clusters in Chinese schizophrenic inpatients. T o improve the usefulness of the scale in China, the present study recommended a better revised scale with re-definition of items into 5 subscales.