医疗质量与患者安全的持续改进

介绍了JCI的患者安全解决方案以及可供借鉴的其他领域的风险管理方法，医疗卫生领域对其他领域改进工具的应用，联合委员会的“医疗改造中心”及其项目以及建立安全文化的内容。

Repeat RF Ablation of C2 and Third Occipital Nerves for Recurrent Occipital Neuralgia and Cervicogenic Headaches

Objective: To address the degree and duration of pain relief from recurrent cervicogenic headaches and/or occipital neuralgia following retreatment with radiofrequency ablation of the C2 dorsal root ganglion and/or third occipital nerves;to review outcomes including duration and degree of pain relief;to evaluate procedure’s complication rate and patient’s willingness to repeat the procedure;to compare effectiveness of the most recent RF ablation to patient’s first RF ablation. Methods: This is a single-center retrospective observational study of 23 patients with recurrent cervicogenic headaches and/or occipital neuralgia treated with repeated RF ablation of the C2 dorsal root ganglion and/or third occipital nerves. All patients receiving treatment from January 2010 to July 2014 are included in this single site retrospective study. This is an IRB approved medical chart review study. Results: 22 of 23 patients underwent follow-up. An average of 86.5% of participants reported pain relief on average of 25.4 weeks at time of follow-up. 41% reported side effects including suboccipital hyperesthesia and/or ear discomfort, 95% reported willingness to repeat the procedure again if severe symptoms recurred, 59% of patients reported the most recent RF ablation had the same results as the first, 32% reported the most recent RF was the most effective, and 9% reported that the first RF was the most effective. Conclusion: Repeated RF ablation is a feasible option for recurrent cervicogenic headaches and/or occipital neuralgia. Effectiveness of repeat intervention is the same or better than the first ablation. Though there was a higher likelihood of side effects including suboccipital neuralgia and/or ear discomfort on repeat treatment, the side effects were generally well tolerated.

关于放射科住院医生物理学教育计划的方法和资源:调查结果

在过去的2年里，通过不懈的努力，我们能够重新评价及建立对放射科住院医生进行物理学教育的方法。通过对来自北美放射科住院医生计划的主管及全体教员的调查以了解教授物理学的方法以及目前所用资源。物理学方面额外的教育资源被证实是必需的，以便更好地把物理学融入到临床培训中，标准化的物理学课程紧密地结合到美国放射学委员会（American Board of Radiology）的初级资格考试中。

卒中介入治疗培训指南：国际多学会共识文件

1背景 缺血性卒中是全球人口死亡和残疾的首要原因。很多急性大血管闭塞（emergent large vesselocclusion，ELVO）患者都会遗留长期残疾。事实上，这些颅内大动脉闭塞经常会导致大面积脑损伤，进而造成患者死亡或严重致残。