1470nm半导体激光治疗膀胱肿瘤的围术期护理

[目的]回顾性分析45例膀胱肿瘤病人行1470nm半导体激光治疗的围术期护理方法和效果。[方法]选取行1470nm激光治疗膀胱肿瘤的45例病人,实施合理和针对性的围术期护理。[结果]病人均顺利接受手术,术后无明显并发症,恢复良好,住院时间缩短。[结论]做好围术期护理和健康教育指导是激光术后取得满意的临床治疗效果的关键。     

下肢动脉硬化闭塞症病人介入治疗的围术期护理

[目的]总结下肢动脉硬化闭塞症病人介入治疗的围术期护理。[方法]对22例下肢动脉硬化闭塞症病人行介入治疗,同时加强围术期护理。[结果]22例病人术后患肢血流均通畅或改善,介入治疗效果好;术后并发假性动脉瘤2例,肢体缺血再灌注损伤1例,均及时发现并得到有效治疗。[结论]加强下肢动脉硬化闭塞症病人介入治疗的围术期护理是手术成功的保证。     

产后大出血介入治疗的围术期护理

[目的]探讨介入治疗产后大出血围术期护理的方法。[方法]回顾性分析30例产后大出血病人经产科保守治疗无效后行子宫动脉栓塞治疗的围术期护理资料。[结果]通过有效的治疗以及积极的护理配合,全部病人止血效果良好,无一例出现再次大出血和其他并发症,月经均恢复正常。[结论]充分做好介入治疗产后大出血的围术期护理,对手术顺利进行、提高介入治疗成功率、减少并发症发生具有重要意义。     

经静脉途径介入治疗硬脑膜动静脉瘘病人的围术期护理

[目的]总结经静脉途径介入治疗硬脑膜动静脉瘘病人的围术期护理。[方法]对11例硬脑膜动静脉瘘病人行经静脉途径介入治疗,术前给予心理护理、专科护理,术中注意皮肤护理、肝素化、配置液态栓塞剂,术后预防并发症护理。[结果]11例病人栓塞治疗后即刻行造影复查,瘘口完全消失8例,部分消失3例,血流速度明显缓慢,无死亡病例;随访时间6个月至2年无加重及复发者。[结论]加强硬脑膜动静脉瘘病人行经静脉途径介入治疗的围术期护理是手术成功的保证。     

右美托咪定在急性脑梗死血管内介入治疗围术期的应用及护理

[目的]探讨急性脑梗死血管内介入治疗围术期应用右美托咪定的镇静效果和护理要点。[方法]回顾性分析南京市江宁医院神经内科2016年6月—2018年12月收治的80例急性脑梗死行血管内介入治疗病人的相关临床资料,所有病人围术期均泵入小剂量右美托咪定镇静。[结果]急性脑梗死血管内介入治疗围术期应用右美托咪定的80例病人浅镇静效果达到满意水平的68例,镇静不足7例,镇静过度5例,护理满意度达到100%。[结论]应用小剂量的右美托咪定在急性脑梗死血管内介入围术期可以使病人躁动减少,术程配合良好,术后不良反应少,达到浅镇静镇痛效果,促进疾病康复。     

痔围术期病人的中西医护理

[目的]探讨痔病人围术期的护理。[方法]回顾性分析268例痔手术病人的护理情况。[结果]268例痔病人术后均痊愈出院,无一例并发症发生。[结论]做好痔病人围术期的护理,可以有效地减少并发症的发生,提高病人术后生活质量。     

子宫肌瘤介入治疗的围术期护理

[目的]探讨子宫肌瘤介入治疗围术期护理措施。[方法]回顾性分析13例子宫肌瘤病人行介入治疗的临床资料。[结果]通过对13例子宫肌瘤病人加强围术期护理,消除了病人恐惧心理,降低了术后并发症,促进病人康复。[结论]加强子宫肌瘤病人围术期护理是保证手术成功、减轻病人痛苦的有效方法。     

反向经皮肾镜钬激光碎石取石术的围术期护理

[目的]总结反向经皮肾-B超定位下应用输尿管软镜钬激光逆行建立经皮肾通道行钬激光碎石取石术病人的围术期护理。[方法]回顾性分析31例B超定位下输尿管软镜钬激光逆行建立经皮肾通道碎石取石术病人的临床资料,总结围术期护理等经验。[结果]31例病人顺利实施手术,一期手术清石率93.54%;术后出血1例,术后出现发热2例,经过积极治疗和有效护理,病人痊愈出院。[结论]反向经皮肾镜钬激光碎石取石术具有定位精准、并发症少、清石率高等优点。做好术前准备及心理护理,术后有针对性地进行专科护理,对减少并发症、促进康复具有重要的意义。     

集束化护理策略在肝癌介入治疗病人围术期中的应用

[目的]观察集束化护理策略在肝癌介入治疗病人围术期中的应用效果。[方法]成立集束化护理策略干预小组及专家团队,通过文献阅读及参考临床指南,制定了完整的、有循证依据的肝癌介入治疗围术期护理策略,包括责任制护理、充分的术前准备、全面的健康教育、严密的病情观察以及周密的术后并发症护理。选取行肝癌介入治疗的住院病人160例,对其实施肝癌介入治疗围术期集束化护理策略。[结果]160例病人术后临床症状明显改善125例,症状稳定35例;无一例发生压疮,无一例发生下肢深静脉血栓,5例发生穿刺点出血,4例出现排便困难,24例出现发热,35例出现恶心、呕吐,30例有肝区胀痛,3例出现明显焦虑,均给予对症护理后症状缓解,且顺利出院。[结论]对肝癌介入治疗病人围术期实施集束化护理策略,可减少病人术后并发症,促进病人术后康复。     

股骨头坏死病人介入治疗的围术期护理

[目的]探讨股骨头坏死病人的围术期护理方法。[方法]回顾性分析在我科住院完善相关检查后确诊需行介入治疗的股骨头坏死病人78例,同时回顾总结在围术期对病人实施的主要护理措施。[结果]78例病人经过系统的、有针对性、有效的围术期护理,术后均无并发症发生,恢复良好,如期康复出院。[结论]对介入治疗股骨头坏死病人给予全面、系统的围术期护理,可以有效预防并发症的发生,促进病人快速康复,提高手术的成功率和病人的生活质量。     

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.     

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.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

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.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.