家庭病床护理模式对脑卒中患者遵医行为的影响研究

目的探讨出院后家庭病床护理模式对脑卒中患者遵医行为的效果。方法将120例出院脑卒中患者按需求分为观察组和对照组各60例,两组患者在院期间的宣教、治疗、护理相同,观察组为家庭病床护理模式,出院时主管医师和主管护士直接与社区卫生服务站交接病情资料,由社区护士继续护理干预;对照组为一般出院模式,不接受社区护理干预。出院后3个月回访比较两组患者遵医行为及对护理服务的满意度。结果两组患者在护理效果上差异有统计学意义,观察组遵医行为及对护理服务满意率明显高于对照组。结论脑卒中患者康复期采用家庭病床护理模式节约医疗资源,提高患者遵医行为和护理满意度,有利于患者康复。     

社区家庭康复护理干预对脑卒中患者出院后康复的影响

目的探讨社区家庭康复护理干预对脑卒中患者出院后康复的效果。方法我科护士主动对出院的53例患者进行6个月的社区家庭康复护理干预。并采用随机方法设立干预组53例和对照组47例,观察两组干预前后的情况。结果日常生活活动能力评定采用现有量表Barthel指数评分,抑郁程度采用汉密尔顿抑郁量表（HAMD）评分,干预6个月后干预组两者评分均优于对照组（P〈0．05）。结论社区家庭康复护理干预能有效提高脑卒中患者的日常生活活动能力,减轻抑郁程度。     

护理团队入驻社区行脑卒中三级康复模式研究

目的探讨护理团队入驻社区行脑卒中三级康复模式的护理效果。方法选取2015年10月~2016年9月我院经治疗后出院的124例脑卒中患者,按随机数字表法分为对照组和研究组,各62例。对照组行常规护理。研究组在对照组的基础上加以护理团队入驻社区行脑卒中三级康复护理模式。比较两组6个月后护理效果。结果研究组护理6个月后Barthel评分以及生活质量评分显著高于对照组(P0.05)。结论护理团队入驻社区行脑卒中患者三级康复护理模式,能够显著提升患者的生活质量和生活能力,促进患者恢复。     

医院-社区-家庭多维护理在脑卒中康复中的应用效果

目的：探讨医院-社区-家庭多维护理在脑卒中康复中的应用效果,拓宽延续护理模式,为脑卒中患者康复开辟更经济、有效、实用的途径。方法选取2013年11月至2014年12月在某三甲医院住院的脑卒中患者522例,将出院后于该医院所在社区街道居住的患者258例纳入实验组,不在该医院社区街道居住的患者264例纳入对照组。医院责任护士、社区护士和家庭共同为实验组患者实施医院-社区-家庭多维护理干预模式,而对照组只采用常规康复护理模式,对522例患者均分别在出院时及出院后6个月进行 ADL 即日常生活活动能力(Barthel 指数)评分、心理 HAMD(汉密顿抑郁量表)评分和患者对护理满意度评分。结果干预后两组患者ADL、HAMD 及满意度评分与干预前比较差异均有统计学意义(P<0.05),且采用医院-社区-家庭多维护理的实验组改善更为明显(P<0.05)。结论医院-社区-家庭多维护理能促进脑卒中患者身心整体康复。     

家庭康复护理对脑卒中偏瘫患者运动功能恢复及生活质量的影响

目的探讨家庭康复护理对脑卒中偏瘫患者运动功能恢复及生活质量的影响。方法根据患者家庭实际情况,将94例脑卒中偏瘫患者分为观察组和对照组,各47例。两组均在院接受系统康复锻炼,对照组出院后根据自身情况进行康复锻炼。观察组进行家庭康复护理干预。比较两组出院时和出院后3个月运动功能评分(采用FMA评分法)和生活质量评分(采用Barthel评分法)。结果两组出院后FMA评分和Barthel评分均较出院时显著提高(P0.05)。观察组出院后3个月FMA评分和Barthel评分显著高于对照组(P0.05)。结论结合脑卒中偏瘫患者家庭实际情况,给予针对性的家庭康复护理,能够进一步改善患者运动功能,促进预后,提升生活质量,是一种较为理想的康复干预方案。     

医院—社区联合中医护理干预对脑卒中患者的影响

目的 探讨医院—社区联合中医护理干预对脑卒中患者社区康复的影响.方法 将2019年1月—12月神经内科住院的首次脑卒中且出院后选择社区康复的患者为研究对象.2019年1月—6月入院的患者60例,设为对照组,给予常规的出院评估、居家康复指导、社区指导康复和随访;2019年7月—12月入院的患者60例,设为观察组,在常规居家、社区康复的基础上,医院—社区联合中医护理干预,为患者提供中医康复指导和中医护理干预.比较两组患者肢体运动功能和日常活动能力,比较实施前后,社区开展中医适宜技术的效果.结果 观察组肢体运动功能、日常活动能力评分均高于对照组,实施后,社区开展适宜技术的项目较前增加(P<0.05).结论 医院—社区联合中医护理干预,可提高社区康复的脑卒中患者的日常活动能力、肢体运动功能,改善患者预后,并有利于社区开展中医适宜技术.     

脑卒中患者家庭康复护理干预及效果评价

目的 探讨家庭护理对提高出院后脑卒中患者康复的意义.家庭护理干预对患者运动功能及日常生活活动能力的影响.方法 选择经治疗好转出院的脑卒中偏瘫患者60例,随机分为干预组和对照组各30例,干预组进行家庭护理干预,每月上门随访指导,对照组采用传统家庭疗养,不施加干预.比较两组患者运动能力、日常生活能力改善情况.结果 出院时两组评分无差异性.6个月后干预组FIM及Barthel评分明显高于对照组(P＜0.01).结论 家庭护理干预能明显改善患者运动能力和日常生活自理能力,提高患者的生活质量.家庭护理延续了康复期脑卒中患者从医院到家庭支持护理,有效地促进了脑卒中康复期患者的康复.     

社区志愿护理对脑卒中患者运动功能和心理康复的影响

目的:探讨志愿护理对社区脑卒中康复患者运动功能与心理康复的干预效果。方法:将50例出院居家康复的脑卒中患者随机分为干预组和对照组各25例。对照组按出院指导实行常规家庭护理,干预组实行延续社区志愿护理。比较两组患者的Barthel指数、Fugl-Meyer运动功能积分、焦虑度。结果:干预组患者Barthel指数、Fugl-Meyer运动功能积分均显著高于对照组(P0.01)。出院3个月干预组患者焦虑度得分显著低于对照组(P0.01)。结论:延续志愿护理有利于社区脑卒中患者运动功能康复和情绪改善,值得推广应用。     

探讨家庭病床康复护理对脑卒中后患者生活质量的影响

目的探讨家庭病床康复护理对脑卒中后患者生活质量的影响。方法将本科脑卒中患者,随机分为康复护理组和对照组各40例。家庭病床康复护理组实施康复护理,对照组实施一般护理。采用FIM量表评定运动能力的独立性,用Barthel指数评定日常生活功能(ADL)。结果 6个月后康复护理组的FIM及ADL评分明显高于对照组,差异具有统计学意义(P0.05)。结论家庭病床康复护理干预能明显改善脑卒中后患者的生活质量。     

Friedman家庭评估模式在康复期脑卒中患者社区护理中的应用

目的探讨Friedman家庭评估模式在康复期脑卒中患者家庭康复中的应用效果。方法采用以家庭为基础的对照试验研究。将80例出院的脑卒中恢复期患者按出院先后顺序随机分为观察组和对照组,各40例。观察组采用Friedman家庭评估模式为指导的家庭康复护理干预。对照组采用常规的出院随访。结果观察组患者在运动功能、日常生活活动能力、生活质量方面均较对照组提高显著,差异有显著意义（P〈0．05）。结论应用Friedman家庭评估模式进行家庭护理干预可有效提高恢复期脑卒中患者的居家康复效果。     

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.     

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.     

自动化酸碱平衡图在急诊社区获得性肺炎诊治中的应用

目的 探讨自动化酸碱平衡图在急诊科社区获得性肺炎(CAP)患者诊断中的价值.方法 根据病史、肺功能测定结果、慢性阻塞性肺疾病(COPD)诊断标准,将111例CAP患者分为单纯CAP组(56例)和COPD合并CAP组[即慢性阻塞性肺疾病急性加重(AECOPD)组,55例].询问患者病史后即刻抽取动脉血测血气并进行自动化酸碱平衡图分析.结果 血气分析结果显示,AECOPD组动脉血二氧化碳分压(PaCO2,kPa)、HCO3- (mmol/L)、剩余碱(BE,mmol/L)均显著高于CAP组(PaCO2:7.714±2.414比5.896±1.308,HCO3-:30.767±7.185比25.014±3.043,BE:4.345±5.371比-0.354±3.180,均P＜0.01).自动化酸碱平衡图分析结果显示,AECOPD组患者酸碱平衡紊乱高达89.1％,CAP组为66.1％.将AECOPD组和CAP组患者中正常(10.9％、33.9％)、急性呼吸性酸中毒(急性呼酸,12.7％、14.3％)、慢性呼吸性酸中毒(慢性呼酸,49.1％、10.7％)、呼吸性碱中毒(呼碱,7.3％、14.3％)、代谢性酸中毒(代酸,12.7％、17.9％)、代谢性碱中毒(代碱,12.7％、8.9％)综合进行x2分析,差异有统计学意义(x2=24.421,P=0.001),而将正常、急性呼酸、呼碱、代酸及代碱进行x2分析,差异无统计学意义(x2=5.280,P=0.260),提示AECOPD患者慢性呼酸的发生率较单纯CAP患者显著增加.结论 自动化酸碱平衡图能帮助急诊科医师快速识别CAP患者是否存在多重酸碱平衡紊乱,并可快速识别急、慢性呼吸系统疾病.