护患情境会话

产妇入院指导 Admission Instructions for aWoman in Labor 交流 (她回到办公室,与营养科联系好了王女士的午餐,翻阅了王女士的门诊病历、围产期检查记录和刚才产房内做的检查结果,准备了体检用物、入院介绍单、孕妇保健手册,来到王女士床旁,见产妇已起床,便问) 护士:小王您休息了一会儿现在感觉如何? 病人:好多了. 护士:现在我给您介绍一下医院的规章制度,好吗? 病人:可以. (李护士把住院须知、作息、陪探、规章制度、病室内设施的应用、物品的存放、信号系统的使用方法、床位医师等一一作了介绍.) 护士:王女士,刚才给您介绍了这么多,能记住吗? 病人:记住了,非常感谢您为我作了如此详细的介绍. 护士:接下来我想帮您量个体温和血压,您喝过热水吗? 病人:没有. 护士:好的,我们开始吧.     

感染性休克与少尿(上)——肾脏病临床选萃(32)

教师:去年秋天我到桂林讲学,该地某军医院请我会诊一个男性病人,主要的临床表现是高热2天后休克和少尿,假如您是我,您该怎么办?甲医生,请你谈谈你的看法好吗! 甲(进修医生):病人每日的尿量有多少!血肌酐和尿素氮的检查结果怎样?     

护士英语简易会话

ＴａｋｉｎｇＢｌｏｏｄＰｒｅｓｓｕｒｅ 　　　　　　　　测量血压Ｎｕｒｓｅ :ＣａｎＩｈｅｌｐｙｏｕ ? 护士 :您有什么不舒服吗 ?Ｐａｔｉｅｎｔ:Ｙｅｓ.Ｉ’ｖｅｇｏｔａｈｅａｄａｃｈｅａｎｄｆｅｅｌｄｉｚｚｙｔｈｉｓｍｏｒｎｉｎｇ . 病人 :是的。今天上午我头痛 ,并且感到头晕不适。Ｎｕｒｓｅ :Ｌｅｔｍｅｔａｋｅｙｏｕｒｂｌｏｏｄｐｒｅｓｓｕｒｅ .Ｗｏｕｌｄｙｏｕｐｌｅａｓｅｒｏｌｌｕｐｙｏｕｒｓｌｅｅｖｅａｎｄｌｉｅｄｏｗｎｏｎｔｈｅｂｅｄ ?护士 :让我来给您量一下血压。请您卷起衣袖 ,躺在床上 ,好吗 ?Ｐａ…     

临床带教

示范给孕妇测量血压 交流 病人:我知道了,谢谢!我的血压怎么样? 教师:170/95 mmHg(1 mmHg=0.133 kPa),虽然比刚入院时好转了,但还是偏高.这与你的饮食习惯可能有关系,想办法控制一下饮食,待会我请营养师来帮您重订一份三餐食谱,好吗? 病人:好的,今天的中饭我就注意,我会按营养师教导我的进餐.     

示范给孕妇测量血压

<正>交流病人:我知道了,谢谢!我的血压怎么样?教师:170/95 mmHg(1 mmHg=0.133 kPa),虽然比刚入院时好转了,但还是偏高。这与你的饮食习惯可能有关系,想办法控制一下饮食,待会我请营养师来帮您重订一份三餐食谱,好吗?病人:好的,今天的中饭我就注意,我会按营养师教导我的进餐。     

护士英语简易会话

ＡｂｄｏｍｉｎａｌＥｘａｍｉｎａｔｉｏｎ　　　　　腹部检查Ｎｕｒｓｅ :Ｎｏｗ ,ｌｅｔｍｅｅｘａｍｉｎｅｙｏｕｒａｂｄｏｍｅｎ .Ｗｉｌｌｙｏｕｌｉｅｄｏｗｎｏｎｙｏｕｒｂａｃｋａｎｄｕｎｔｉｅｙｏｕｒｂｅｌｔ?护士 :现在 ,让我来为您做腹部检查。请您仰卧在床上并解开腰带好吗 ?Ｐａｔｉｅｎｔ:ＯＫ .病人 :好的。Ｎｕｒｓｅ :Ｐｌｅａｓｅｂｅｎｄｙｏｕｒｋｎｅｅｓｕｐａｎｄｂｒｅａｔｈｅｄｅｅｐｌｙ .ＤｏｙｏｕｆｅｅｌａｎｙｐａｉｎｗｈｅｎＩｐｒｅｓｓｈｅｒｅ ?护士 :请您把双腿蜷起来 ,做深呼吸。我按这儿时您…     

输液带教

<正>交流护生:你叫李丽吗?今天你发高烧了,医生给你开了药,现在我给你打针,好吗?李丽:一定很痛,我不要打针!李丽母亲:我女儿血管细,不好打,请你的老师看看吧!张老师:好的,我来看看。哦,血管确实很细。我来帮你打吧。李丽,别怕,会有一点痛像蚊子咬一样,很快就好了。(打完后)好了,你很勇敢,还痛吗?李丽:还好,不痛了。护生:张老师,对这样的小病人,我们在为她作静脉输液时要注意些什么?张老师:首先,我们要让小病人配合我们的治疗,刚才     

护士英语简易会话

IntravenousInfusion　　　　　静脉输液Nurse:Goodmorning,Mr.Zhang .It’stimeformetogiveyouintravenousinfusion . 护士 :张先生 ,上午好 !该给您输液了。Patient:Excuseme ,couldyoutellmeabouttheuseoftheIVflu ids? 病人 :对不起 ,您能告诉我输这些液体的作用吗 ?Nurse :Ofcourse .Thefluidscanprovideenergyforyouandpre ventyoufromelectrolyticimbalancesafteroperation .护士 :当然可以。输入的液体能为您提供能量 ,还可预防术后电解质失衡。Patient:Wouldyoupleaseletthefluiddropmorequickly ?病人 :请您把液体滴速调快…     

护患情境会话

悲哀疏导 交流 护士:夫人,我想,如果您先生您知道现在这个样子一定会很难过的.九泉之下,他会一直牵挂着您,您能忍心让他难过吗? (夫人:面带哀色地沉默着) (护士坐下,轻轻地握住夫人的手,轻轻地抚摸,像女儿一般……约2分钟后) 护士:您看,您的手冰凉,手指都凹陷了.如果还不吃东西,您会挺不住的.您的儿子给您炖了鸡汤,还热着呢,喝一点,好吗?     

DIALOGUE

A:您好。B:喂,是555-1970号吗?我想和冯先生讲话。A:对不起,冯先生现在不在。B:您能告诉我他什么时候回来吗?A:我不清楚,不过他肯定会回来吃午饭的。我是他的妻子要我转告吗?B:谢谢您。请转告他务必在飞机起飞前一小时到达机场。A:好的。他一回来我就告诉他。请告诉我您的名字?     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."