远程遥控血压监护567例临床分析

目的 对高血压患者进行远程遥控血压监护(RBPM),分析血压类型,血压变异.方法 应用安立凯高血压监控系统,对住院高血压患者567例进行RBPM.结果 反勺型高血压、非勺型高血压、勺型高血压、超勺型高血压分别为32例、325例、184例、26例,分别占6%、57%、32%、5%.早晨高血共255例,占高血压患者的44.98%,其中夜间持续性高血压164例,占28.92%,晨峰高血压91例,占16.05%.反勺型高血压、超勺型高血压患者血压变异较大.结论 非勺型高血压、早晨高血压是一普遍现象,反勺型高血压、超勺型高血压患者血压变异较大.     

社区综合护理对原发性高血压的干预效果研究

目的 探讨社区原发性高血压患者的最佳护理干预方法,以促进其健康. 方法 对140例社区高血压患者进行为期2年的系统的管理和社区干预,具体措施包括加强社区联系,普及健康知识,提高居民对高血压危害的认识,对原发性高血压患者实施专案管理,对高血压患者进行跟踪监测和督导服药等.比较干预前后患者高血压防治知识知晓率,高血压相关心脑血管并发症发生率及控制高血压行为的形成率.进行χ2检验. 结果 系统的管理和社区干预提高了高血压患者高血压知识知晓率,促进了高血压患者规律服药,降低了高血压引起的心脑血管并发症,提高了高血压患者控制高血压行为的形成率. 结论 实施社区护理干预,对社区原发性高血压防治切实有效,值得社区医疗机构推广运用.     

妊娠期高血压疾病患者产后抗高血压治疗的探讨

目的 探讨妊娠期高血压疾病患者产后抗高血压治疗意义.方法 对2010～2011年中3 231例分娩产妇进行观察.对其中的424例合并有妊娠期高血压的产妇进行前瞻性对照观察.根据产妇对抗高血压治疗的依从性分为对照组和非对照组,对两组产妇产后高血压的转归进行分析,经统计学处理,探讨其意义.结果 治疗组产后高血压恢复正常时间短,尿蛋白转阴快,高血压遗留率低.结论 妊娠期高血压孕妇产后高血压及蛋白尿并未恢复正常,产后继续抗高血压治疗可加快妊娠期高血压疾病患者的早日康复,降低高血压遗留率.     

妊娠合并高血压的合理用药

妊娠期合并高血压临床上包括以下3种情况：妊娠高血压综合征、原发性高血压及慢性肾炎（高血压）。其中最常见类型为妊娠高血压综合征。     

社区综合护理对原发性高血压的干预效果研究

目的探讨社区原发性高血压患者的最佳护理干预方法,以促进其健康。方法对140例社区高血压患者进行为期2年的系统的管理和社区干预,具体措施包括加强社区联系,普及健康知识,提高居民对高血压危害的认识,对原发性高血压患者实施专案管理,对高血压患者进行跟踪监测和督导服药等。比较干预前后患者高血压防治知识知晓率,高血压相关心脑血管并发症发生率及控制高血压行为的形成率。进行,检验。结果系统的管理和社区干预提高了高血压患者高血压知识知晓率,促进了高血压患者规律服药,降低了高血压引起的心脑血管并发症,提高了高血压患者控制高血压行为的形成率。结论实施社区护理干预,对社区原发性高血压防治切实有效,值得社区医疗机构推广运用。     

160例急诊高血压危象的紧急处理与分析

目的探讨高血压危象评估和处理原则及对高血压危象急诊处理的指导意义。方法依据高血压危象评估和处理原则对2008年1月2009年12月期间收治的160例高血压危象患者进行诊断和治疗。结果 160例高血压危象患者中,高血压急症134例,高血压亚急症26例。高血压急症中,以心脑血管病变为主,包括脑卒中、急性冠脉综合征和急性左侧心力衰竭。依据高血压危象评估和处理原则进行急诊处理,能够对高血压危象进行准确评估和有效处理,减少诊治失误,降低死亡率并改善预后。结论有关高血压危象的评估和处理原则能够指导高血压危象的急诊处理,取得良好的预后。     

肾性高血压发病机制及治疗

高血压按照病因可以分为原发性高血压和继发性高血压,继发性高血压分很多种类型,由肾疾病所导致的血压升高称之为肾性高血压,肾性高血压是最常见的继发性高血压类型,在一般高血压人群中患病率约为0.05%~5%左右,并且在严重的高血压和终末期肾病的患者中肾性高血压的患病率更高,在老年肾透析的患者中可达25%左右[1]。对于已有肾疾病和(或)糖尿病的患者,即使是轻度至中度高血压,对加速肾损害的敏感性也大大增强。     

青少年高血压及高血压前期的诊治进展

高血压常被认为是成年人的病症,实际上青少年高血压及高血压前期均不少见。目前全球成人高血压发病率为24%~60%,高血压前期22%~25%[1],青少年高血压发病率为0.5%~9.5%[2]。研究表明,成人原发性高血压源于青少年,青少年高血压与成人期心血管疾病的发病率及病死率之间存在联系,对     

中医药防治高血压肾损害临床研究进展

我国现有高血压患者2亿多,肾脏是高血压损害的靶器官之一。临床上将高血压造成的肾脏结构和功能的改变称为高血压肾损害,主要表现为小动脉肾硬化。积极稳妥地控制高血压是治疗高血压肾损害的关键。中医药在配合降压治疗高血压肾损害方面有一定优势。近年来中医药防治高血压肾损害取得一定成效,现综述如下。     

高血压阳性家族史大学新生的现况调查

目的调查高血压阳性家族史大学新生的一般情况、家族史、高血压患病率及相关知识知晓率,为高血压阳性家族史健康子代的一级预防提供依据。方法采用横断面研究,选择2011年9月成都市某大学进行常规体检的新生,以体检及调查表的形式了解高血压阳性家族史新生的基线情况、家族史情况、高血压患病率以及相关知识知晓率。结果共筛查7044例大学新生,其中557例有高血压家族史,28例确诊为高血压,患病率为5.0%。在筛查的新生中,对高血压相关知识完全不了解、一般了解及很了解的比例分别为21.4%、74.7%和3.9%。与无高血压家族史的新生相比,高血压阳性家族史新生有更多的一级亲属高血压病史、多个亲属高血压病史、糖尿病家族史及高脂血症家族史(P<0.05)。结论高血压阳性家族史大学新生的高血压患病率并不高,但其高血压相关知识知晓率较低。对于这部分人群,应严格评价其一级亲属高血压病史、多个亲属高血压病史、糖尿病及高脂血症家族史,进行危险因素的早期防控。     

The European Trauma Course (ETC) and the team approach: Past,present and future

The European Trauma Course (ETC) was officially launched during the international conference of the European Resuscitation Council (ERC) in 2008. The ETC was developed on behalf of ESTES (European Society of Trauma and Emergency Surgery), EuSEM (European Society of Emergency Medicine), the ESA (European Society of Anaesthesiology) and the ERC. The objective of the ETC is to provide an internationally recognised and certified life support course, and to teach healthcare professionals the key principles of the initial care of severely injured patients. Its core elements, that differentiates it from other trauma courses, are a strong focus on team training and a novel modular design that is adaptable to the differing regional European requirements.This article describes the lessons learnt during the European Trauma Course development and provides an outline of the planned future development.     

Inpatient stroke rehabilitation: a comparative study of admission criteria to stroke rehabilitation units in four European centres.

OBJECTIVE: To explore the clinical and non-clinical factors involved in decision-making concerning admission to European stroke rehabilitation units. DESIGN: Observational study on case-mix at intake combined with questionnaires and semi-structured interviews with the medical consultants of each European stroke rehabilitation unit. PATIENTS AND SETTINGS: Clinical data on 532 first-ever patients after stroke. Medical consultants from 6 European stroke rehabilitation units in 4 European countries (UK, Belgium, Germany and Switzerland). METHODS: Standardized clinical assessments within 2 days after admission. Questionnaires to each medical consultants followed by a qualitative round of semi-structured interviews. RESULTS: Case-mix of patients after stroke was significantly different between European stroke rehabilitation units. Clinical criteria for admission were seldom explicit and were evaluated differently between the European stroke rehabilitation units. In the UK units, diagnosis of stroke was the only criterion for admission. In the Belgian, German and Swiss units, pre-morbid conditions were taken into account in admission decisions. The likelihood of discharge home was considered highly important in the Swiss units. CONCLUSION: Case-mix differences at intake could be linked to different appraisals of clinical and non-clinical factors of patients after stroke. The findings urge us to be more explicit about decision-making processes at admission in order to provide a more comprehensive insight into the interplay between context and process of care.     

Applying to the European Research Area Network Scheme (ERA-NET): collaborative working for nursing and midwifery research

AIM: This paper reports on work undertaken to achieve an application for monies from the European Commission's 6th Framework Programme by some key stakeholders, working with a nursing and midwifery research agenda at national policy levels. BACKGROUND: A short outline of the European Commission's European Research Area Network scheme is given in order to set the paper in context, and the vision underpinning the application is discussed. CONCLUSION: The paper describes the processes that were undertaken to bring to fruition such collaborative work, and some key lessons are outlined. Seeking opportunities to enhance nursing and midwifery research within a European context gives value to the application, which was ultimately successful.     

Report of the 1st meeting of the "Vienna Initiative to Save European Academic Research (VISAER)"

The European Directive 2001/20/EC ("Clinical Trials Directive") was aimed at simplifying and harmonising European clinical research. The directive's attempt represents an important step because many European Member States lack national laws that specifically address details of research, but the goal has been only partly achieved. For academic investigators doing national or multi-national research the new European law and the requirements following its implementation are likely to have the opposite effect. Some areas seem to be of particular concern: trial sponsorship, the ethical review process, the participation of patients who are temporarily not able to consent in clinical trials, in particular the informed consent process, an accepted European registry for all clinical trials, insurance and pharmacovigilance. Furthermore there are fundamental problems of the conduct of clinical trials that could have been foreseen at the time of implementation of the new law, which are impeding academic basic clinical research. The bureaucratic burden for academic investigators has tremendously increased without representing any contribution to patients' safety or to the scientific value of research. Furthermore some large European academic trials cannot be conducted anymore due to the new regulations. This result in a reduction in the number of trials and additionally in a reduction in the number of patients enrolled in a study. European research and thus European patients will suffer from the loss of potential benefits of research. The Vienna Initiative to Save European Academic Research (VISEAR) brings together leading stakeholders from academic research groups and interested parties from industry, international organisations and regulatory authorities to focus on the issues of concern regarding the organisational and funding of academic clinical research in order to improve the development and use of medicines in Europe. The first step of the initiative was a meeting held on May 30, 2005 in Vienna. The resumés of the six parallel working groups are presented in this supplement of the Wiener Klinische Wochenschrift, a position paper with recommendations in relation to the EU Clinical Trials Directive and medical research involving incapacitated adults has been published separately.     

FESCC survey on accreditation and post-graduate training in clinical chemistry in European countries. Federation of European Societies of Clinical Chemistry.

Promotion of the professional growth and development of specialists in the field of clinical chemistry in European countries, and harmonisation of quality assessment and accreditation procedures are listed among the main goals and activities of Federation of European Societies of Clinical Chemistry (FESCC), according to its 1999-2000 strategic plan. The European countries that are members of the European Union are in the process of establishing the "European Register for Clinical Chemists", based on minimum standards of education, training and experience as defined by the European Communities Confederation of Clinical Chemists (EC4). Many other European countries would like to adapt their system of professional education to this model. Data on post-graduate training in EC4 FESCC members have already been gathered in 1998. However, at the present time, there is no detailed knowledge of pre- and post-graduate professional education of specialists in clinical chemistry in the non-EC4 European countries. FESCC launched a survey in July 1998 in order to gather this information with the hope to start a database about existing systems. All FESCC members received the same questionnaire on accreditation (seven questions) and non-EC4 FESCC members received an additional questionnaire with 11 questions related to post-graduate training in clinical chemistry. The response rate of the 35 FESCC member countries was 93% from the 15 EC4 members (14 responses/15 countries) and 80% from the 20-non-EC4 (16 responses/20 countries). The heterogeneity of the data on post-graduate training in clinical chemistry indicates that a great effort will be needed before harmonisation is reached. These results, however, will provide an interesting basis for further discussion and promotion of post-graduate training in clinical chemistry. The data provided on accreditation show that the total number of accredited laboratories was relatively low in EC4 countries and even lower in non-EC4 members. It was not surprising to see that the number of accredited laboratories was the highest in the two countries which started accreditation the earliest (i.e. Sweden and UK, 1992). This situation, however, is changing at a fast rate in most countries and the number of the accredited sites is expected to increase rapidly in the next few years.     

Multiple Authorship and Article Type in Journals of Urology across the Atlantic: Trends over the Past Six Decades

Objective: The aim of this research was to study the trends in authorship and type of article in European and North American journals of urology over the past 6 decades. Materials and Methods: Using a self-developed Visual Basic program, the number of authors per article and the type of article in four European journals (BJU International, Current Opinion in Urology, European Urology and Urologia Internationalis) and four North American journals (Journal of Urology, Urologic Clinics of North America, Urology and World Journal of Urology) were extracted from the PubMed website from January 1946 to October 2010, and the number of authors per article in each year was calculated in all the journals. Results: The average number of authors per article has increased and the percentage of single-author articles has decreased in both European and American journals. An increase in the number of authors per article was observed mainly in original articles and case reports. Since the early 1980s, there has also been a decreasing percentage of published case reports and a general increase in the percentage of letters to the editor and editorials. Conclusions: The multiple-authorship trends observed in both European and North American urology journals were similar and appeared to be mainly due to changes in original articles and case reports.     

Cardiovascular reflex responses in Bangladeshi and European subjects.

1. Cardiovascular responses to three different interventions, namely the Valsalva manoeuvre, deep breathing and a cold stimulus on the face, were studied in two ethnic groups (European and Bangladeshi) that have been shown to differ in the prevalence of hypertensive-vascular disease. The data obtained consisted of systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate measured by using a beat-by-beat non-invasive blood pressure monitor (the Finapres), forearm blood flow determined by venous occlusion plethysmography, and calculated forearm vascular resistance. 2. The resting haemodynamic status was similar in European and Bangladeshi subjects. However, Bangladeshi subjects showed a greater increase in heart rate, but only after 20 s into the Valsalva manoeuvre, and greater overshoots in mean blood pressure after the manoeuvre than the European subjects. Furthermore, after cold face stimulation the fall in forearm vascular resistance to baseline levels was delayed in Bangladeshi subjects relative to that in the European subjects. 3. There were no inter-group differences in the reflex bradycardia relative to mean blood pressure or in the cardiac baroreflex sensitivity estimated from systolic blood pressure and pulse interval after the Valsalva manoeuvre. In addition, values for the mean difference between maximum and minimum pulse intervals during deep breathing did not differ in Bangladeshi and European subjects. 4. These findings together suggest that, although cardiac vagal reflex responses appear similar in the two groups, sympatho-adrenal influences on the heart and vasculature may be greater in Bangladeshi subjects than in European subjects.