Conceptual problems in current research on cognitive vulnerability to psychopathology

Four problems with the concepts used in research on the role of cognitions in psychopathological conditions are identified. The concepts are too intricate or too isolated, are too indistinguishable, and are too incontrovertible. The difficulties presented to the researcher by the use of such concepts are described and alternative approaches are recommended.     

钠离子紊乱病因及神经系统并发症

钠离子紊乱是临床常见的电解质紊乱,其可导致神经系统并发症;神经系统表现多为功能性改变,如果及时合理纠正,症状通常可逆。相反,如果不恰当处理,则可导致症状加重,出现不可逆性损害,甚至导致患者死亡。因此,有效的识别和治疗钠离子紊乱以及积极处理导致电解质紊乱的原发疾病极为重要。本章主要阐述低钠血症与高钠血症的病因,所致神经系统并发症的相关机制、临床表现及其治疗。     

Current applications of biomarkers in cardiomyopathies

Cardiomyopathies are an important cause of sudden cardiac death in young people and are responsible for arrhythmias and premature heart failure in all age groups. Although many cardiomyopathies are inherited, biochemical markers are a fundamental part of the diagnostic work-up and are useful in the prognostic assessment of disease. In this article, the authors review the rationale and evidence for important biomarkers according to their role in patient management. Emerging biomarkers are briefly reviewed, alongside modern scientific approaches to biomarker discovery.     

常见肋骨肿瘤和肿瘤样病变的CT诊断

目的:讨论肋骨肿瘤和肿瘤样病变的CT表现以及各自的特点。材料与方法:取经手术和病理证实,或临床动态观察证实的肋骨病变50例。所有病例均行X线、CT检查。2例行MRI检查。结果:32例为良性病变,其中12例为骨岛,9例为骨纤维异常增殖症,7例为软骨类良性肿瘤,4例为骨感染性病变(2例为结核,2例为非特异性感染)。恶性病变18例,其中转移瘤10例,骨髓瘤4例,骨巨细胞瘤4例。结论:常见的肋骨肿瘤和肿瘤样病变一般都具有某些有助于我们诊断的特征性的CT表现。多数情况下,我们都能通过这些CT表现较好的区分常见的肋骨肿瘤和肿瘤样病变。     

手术患者“边缘时间”的安全护理

现代医院手术室每日接待大量的手术患者,虽然都已经认识到各种风险的存在,但往往把目光集中在手术间内,而容易忽略手术前、后病人在转运过程“边缘时间”的安全。文章总结、分析了以往手术前后“边缘时间”存在的风险,设置了合理的接送程序;使用患者身份识别腕带的“五查对制度”;采取搬运患者前的“一查、二看、三整理、四搬运”等护理对策。     

Multichannel data acquisition system for mapping the electrical activity of the heart

BACKGROUND: Details of the electrical conduction pattern of the heart are revealed to the electrophysiologist when multichannel data are used for activation mapping. Commercial electronic systems are available for simultaneous acquisition of many surface electrograms; however, the cost of these systems may be prohibitive and they can be mostly inflexible for adaptation to other research projects. Furthermore, the hardware and software design is often proprietary. In this article we describe the in-house design and implementation of a 320-multichannel acquisition system for animal electrophysiologic research. METHOD AND RESULTS: Several modules comprise this system. The multichannel data are first preprocessed by amplification, filtering, and analog multiplexing. An algorithm for automatic adjustment of signal gains is implemented to maximize the voltage resolution and minimize noise pickup. Signals are then digitized, and sequenced to order the multichannel data and to add markers required for analysis. The digital data are streamed to archival storage media. Additionally, the electrocardiogram (ECG), blood pressure, and stimulus channel signals are stored simultaneously. Selected signals are then displayed in real-time for measurement and analysis and as a check of the system integrity. Examples of multielectrode arrays and surface recordings are provided. Costs for building such a system are estimated. CONCLUSIONS: Multichannel data acquisition systems that are designed and constructed in-house have several advantages over turnkey commercial systems, including the potential for considerable cost savings, flexibility in acquiring data, and the ability to subsequently add additional components.     

Beyond the art of governmentality: unmasking the distributional consequences of health policies

The aim of this article is to critique health policy discourses that are taken for granted. This perspective will allow for the identification of 'exclusionary' health policies, which we define as policies that are thought to offer universal benefit, despite yielding adverse effects for significant groups of people in society. As such, policies that are said to be designed 'for all' frequently benefit only a subset of the population. Our intent is to highlight the distributional consequences of certain health policies that are largely institutionalized in contemporary society. We believe that these distributional effects are explicit representations of power in society and that institutions may provide individual 'choice' and 'freedom' that, in turn, yields separation as an outcome, a separating equilibrium. Specifically, if those who benefit from policies of partition are numerous and are to obtain significant advantage or incur limited costs, or if those who are adversely affected are scarce (or hidden), or the size of these adverse effects are small (or perceived to be minor), then partition becomes more likely as a 'legitimate', but exclusionary, instrument of public policy.     

The sexual offender: Monster,victim, or everyman?

The nature of sexual offending is considered and it is concluded that offenders are more like other people than they are different. It is concluded that they are neither monsters nor victims and should, as a consequence, be treated like all other clients. Treatment implications are considered and it is suggested that we shift our focus away from a preoccupation with procedures and instead give attention to process features of treatment. Various therapist styles are discussed and it is proposed that a style that enhances the offender's self-esteem may be best. The value of this approach is outlined and tentative data are offered suggesting its value. Considerations for future developments are noted.Keynote address at the 14th Annual Research and Treatment Conference of the Association for the Treatment of Sexual Abusers, New Orleans, October 1995.     

Thermal Ablation for Primary and Metastatic Hepatic Malignancies

Surgical resection offers the best hope for long-term survival in both hepatocellular carcinoma patients and those with metastatic liver disease. Patients most likely to benefit are those with a single tumor and well-preserved liver function, who have normal serum bilirubin and normal portal flow. Patients are often ineligible for resection for a variety of reasons. Ablative options, such as cryoablation and radiofrequency ablation (RFA), are minimally invasive procedures particularly suited for those patients who are felt to be poor surgical risks. These options are based on the principle that decreasing the volume of viable tumor or preventing new tumor growth can lead to longer survival and potential cure in selected patients. Complications related to these procedures are minimal compared with open surgery. The most common complications are bleeding and infection.     

血小板致动脉粥样硬化作用机制的研究进展

血小板是由骨髓巨核细胞生成的一类重要血细胞,主要参与机体止血、凝血、血栓形成及器官移植排斥等,且在维持机体血管损伤修复平衡、保持内环境稳定等方面起重要作用。血小板还可与多种细胞及因子结合,参与级联炎症反应,促进动脉粥样硬化形成。血小板通过各种表面受体、胞内信号转导分子、多种细胞因子实现其功能。血小板及相关分子的研究和应用,对于阐述动脉粥样硬化病变的发生机制十分重要,在监测心血管事件的发生发展中具有潜在的应用前景。     

Tumors of the urinary bladder: technique,current use,and perspectives of MR and CT cystography

In comparison with other applications of virtual endoscopy, reports about virtual cystocopy are limited. In this update article, the various techniques of magnetic resonance (MR) and computed tomographic (CT) cystography are explained with their inherent advantages and disadvantages. The principal methods of postprocessing are presented, and future technical developments of MR and CT cystography are described. The present clinical applications and the possible role of MR and CT cystography in the future are discussed.     

Concept Analysis of Fear

The nursing diagnosis fear is clarified through the technique of concept analysis. Uses of the concept of fear in prominent theories of human behavior and in nursing arc reviewed. Five critical attributes occurring in all cases of fear are identified—a model case, a related case, a contrary case, and an illegitimate case are presented. Antecedents lo fear are derived Cunsequences of fear are discussed and are related to nursing interventions. Empirical referents that demonstrate occurrence of the concept of fear are determined, classified, and related to critical attributes. This concept analysis provides an essential conceptual base for instrument development and clinical research on fear.     

Advanced Statistics: Up with Odds Ratios! A Case for Odds Ratios When Outcomes Are Common

Treatment comparisons from clinical studies involving dichotomous outcomes are often summarized using risk ratios. Risk ratios are typically used because the underlying statistical model is often consistent with the underlying biological mechanism of the treatment and they are easily interpretable. The use of odds ratios to summarize treatment effects has been discouraged, especially in studies in which outcomes are common, largely because odds ratios differ from risk ratios and are frequently interpreted incorrectly as risk ratios. In this article, the author contends that risk ratios can be easily misinterpreted and that, in many cases, odds ratios should be preferred, especially in studies in which outcomes are common.     

Hollow Viscus Injury

Background: Hollow viscus injuries are uncommon and occur in approximately 1% of all blunt trauma patients. Discussion: These injuries are often not suspected and are difficult to diagnosis. Morbidity and mortality are high, and a negative abdominal computed tomography is not sufficient to rule out these injuries in certain clinical scenarios. Conclusion: Using a case-based approach, the epidemiology and diagnostic pathways to manage hollow viscus injuries are reviewed.     

Measuring the effects of casemix on outcomes

Participation in the measurement of population health and health care outcomes has become an explicit professional duty for doctors, but comparisons are difficult to make because outcomes are conceptually complex and largely qualitative. Observational data, particularly from routine hospital statistics, are useful complements to experimental data provided that their variable quality is taken into account and adjustments are made to minimize bias and confounding and to allow for the effects of differences in casemix, which are problematic because of the nature of severity.     

Treating real people: Science and humanity

Something important is happening in applied, interdisciplinary research, particularly in the field of applied health research. The vast array of papers in this edition are evidence of a broad change in thinking across an impressive range of practice and academic areas. The problems of complexity, the rise of chronic conditions, overdiagnosis, co‐morbidity, and multi‐morbidity are serious and challenging, but we are rising to that challenge. Key conceptions regarding science, evidence, disease, clinical judgement, and health and social care are being revised and their relationships reconsidered: Boundaries are indeed being redrawn; reasoning is being made “fit for practice.” Ideas like “person‐centred care” are no longer phrases with potential to be helpful in some yet‐to‐be‐clarified way: Theorists and practitioners are working in collaboration to give them substantive import and application.     

国内外慢性肾脏病症状群研究的文献计量学分析

目的探索国内外慢性肾脏病症状群的研究发展态势,为今后临床护理研究提供循证依据。方法检索2001年1月至2020年12月期间发表在PubMed、Web of Science、EBSCO、The Cochrane Library、中国知网、万方数据知识服务平台、中国生物医学文献数据库的慢性肾脏病症状群研究的相关文献,对文献外部特征信息和研究内容进行文献计量学分析。结果最终纳入32篇文献,最早发表于2007年,其中横断面研究18篇,纵向研究3篇,队列研究2篇,干预性研究2篇,量表的编制及跨文化调试2篇,质性研究1篇,综述4篇。纳入的研究虽然在研究设计、样本特征、评估工具和分析方法等方面存在差异,但主要结果基本相同,神经肌肉/疼痛症状群、胃肠道症状群、尿毒症症状群、皮肤症状群等在慢性肾脏病患者中比较常见。结论目前国内外对慢性肾脏病症状群研究处于初始探索阶段,研究结果尚不稳定。未来可对慢性肾脏病症状群的评估方法、发生机制等深入研究,并探讨相应症状管理策略。     

Anticandidal low molecular compounds from higher plants with special reference to compounds from essential oils

The most active low molecular weight compounds from higher plants against Candida species are compiled from a database of antimicrobials (Amicbase) to find out new hints on their mechanism of action. The selected compounds possess strong inhibitory activities in vitro against Candida species either in the agar diffusion test, bioautography, agar dilution test, serial dilution test, or activity in the vapour phase. The test conditions are listed thoroughly and aspects of the different methods and recent developments in the testing of anticandidal drugs are discussed. The anticandidal spectra of drugs, antiseptics, and disinfectants licensed on the major markets are given for comparison of activities with compounds from natural sources. So far known mechanisms of action are described and some new structure-activity relationships are deduced from relationships between biological activities and chemical and physical parameters. Main specific targets of natural anticandidals are the ergosterol pathway, respiratory chain, and chitin biosynthesis.     

Materials in particulate form for tissue engineering. 1. Basic concepts

For biomedical applications, materials small in size are growing in importance. In an era where 'nano' is the new trend, micro- and nano-materials are in the forefront of developments. Materials in the particulate form aim to designate systems with a reduced size, such as micro- and nanoparticles. These systems can be produced starting from a diversity of materials, of which polymers are the most used. Similarly, a multitude of methods are used to produce particulate systems, and both materials and methods are critically reviewed here. Among the varied applications that materials in the particulate form can have, drug delivery systems are probably the most prominent, as these have been in the forefront of interest for biomedical applications. The basic concepts pertaining to drug delivery are summarized, and the role of polymers as drug delivery systems conclude this review.     

Development of a sexual assault evidence collection kit – The need for standardization in Turkey

Sexual offences are recognized to be one of the most critical of crimes throughout the world. In Turkey, forcible rapes show, in the sexual crime rates, an increase of approximately 3% every year. It becomes even more critical, when realizing that less than half of all rapes, which are believed to occur, are reported to law enforcement, and of those few assailants who are arrested even fewer are convicted of rape. Often, little or no knowledge of the correct methods of locating, recovering, packaging, and preserving evidence specimens are the causes for compromising the forensic examination in court. This problem occurs when medical personnel are not adequately trained or properly advised in the evidentiary aspects and medical features of treating a victim.