脑卒中维持性康复100例疗效观察

目的：探讨维持性康复对脑卒中预后的影响。方法：急性脑卒中患者１９０例,随机分为康复组及对照组。康复组在临床治疗的同时进行早期康复及维持性康复,对照组仅给临床常规治疗,分别于第１～６周、３个月、６个月、１２个月时对两组进行单盲评定。运动功能用Ｆｕｇｌ－Ｍｅｙｅｒ评分,日常生活活动（ＡＤＬ）用Ｂａｒｔｈｅｌ指数评分,神经缺损用神经功能缺损程度评分标准评分。结果：康复组Ｆｕｇｌ－Ｍｅｙｅｒ及Ｂａｒｔｈｅｌ指数得分明显优于对照组（Ｐ＜０．００５）,神经功能缺损程度康复组比对照组减少更显著（Ｐ＜０．００１）,一年后这种差异依然存在。结论：急性脑卒中患者进行早期康复,能明显改善肢体运动功能及生活自理能力。维持性康复能影响远期疗效,有助于回归社会。     

脑卒中患者的早期康复治疗

目的观察早期康复对急性脑卒中的疗效。方法７０例脑卒中患随机分为早期康复组（３５例）和一般治疗组（３５例）,两组均进行脑卒中常规治疗,前加用Ｂｏｂａｔｈ和Ｂ为主的促通技术,治疗前后用神经功能缺损评分、Ｂａｒｔｈｅｌ指数和Ｆｕｇｌ－Ｍｅｙｅｒ评分进行评估。结果早期康复组的３种评分均显优于一般治疗组（Ｐ均＜０．０５）。结论急性脑卒中的早期康复治疗是有效的。     

急性脑卒中患者早期康复治疗对日常生活能力的影响

目的：探讨急性脑卒中患者早期康复治疗对日常生活能力的影响。方法：１：１配对研究。应用神经功能缺损程度和改良Ｂａｒｔｈｅｌ指数（ＭＢＩ）为量表评定早期康复的治疗效果,研究３２例急性脑卒中患者的临床资料并进行统计学处理。结果：神经功能缺损程度评分和ＭＢＩ在一疗程后两组有明显差异（Ｐ＜０．０５和Ｐ＜０．０１）结论：急性脑卒中患者在病情稳定后进行早期康复治疗可以提高患者的日常生活能力。     

早期康复护理干预对改善脑卒中病人ADL的探讨

目的探讨早期康复护理干预对急性脑卒中偏瘫患者的运动功能、平衡功能、日常生活活动能力（ＡＤＬ）的影响。方法脑卒中偏瘫患者６０例,对其中３０例患者实施早期康复计划（康复组）,另外３０例患者给予神经内科一般治疗（对照组）。结果两组治疗前,治疗后一个月分别给予 Ｆｕｇｌ－Ｍｅｙｅｒ评测法和ＦＩＭ评测法,对患者肢体的残损程度和活动功能进行评定,经过统计学检验得出：治疗前评测,两组无明显差异（Ｐ＞０．０５）。治疗后１个月评测,康复组明显优于对照组（Ｐ＜０．０１）。结论早期给予康复护理干预可以明显改善急性脑卒中偏瘫患者的肢体运动和平衡功能及ＡＤＬ。     

Bobath疗法对脑出血偏瘫的早期康复疗效观察

目的 探讨脑出血偏瘫的早期康复治疗的疗效。方法 对３０例脑出血偏瘫病人应用Ｂｏｂａｔｈ技术进行早期康复锻炼,疗程１个月。采用临床神经功能缺损程度评分,简式ＦｕｇＩ－Ｍｅｙｅｒ运动功能评分（ＦＭＡ）,改良Ｂａｒｔｈｅｌ指数（ＭＢＩ）于初期和末期（１个月）对患进行评定。结果 治疗后治疗组临床神经功能缺损评分与对照组比较明显减少（Ｐ〈０．０１）;ＦＭＡ、ＭＢＩ明显高于对照组（Ｐ〈０．０１）结论 早期康     

早期作业疗法对脑卒中患者的康复作用

摘要：目的 更快、更有效地促进脑卒中患者全面康复。方法 将７２例脑卒中患者随机分为２组，观察组３６例在生命征稳定后采用运动疗法（ＰＴ）的同时实行系统的作业疗法（ＯＴ），对照组３６例在生命体征稳定后进行ＰＴ２周后增加ＯＴ，疗程均为６周。于治疗前、治疗２、４、６周时进行神经功能缺失（ＦＭＡ）评分和改良Ｂａｒｔｈｅｌ指数（ＭＢＩ）评分。结果治疗后２、４、６周ＦＭＡ、ＭＢＩ评分两组与治疗前比较显著提高（均Ｐ＜０．０５），且观察组显著高于对照组（均Ｐ＜０．０５）。结论 ＯＴ的早期应用可促进脑卒中患者全面康复，与ＰＴ同时进行可显著提高疗效。关键词：脑卒中；　作业疗法；　运动疗法；　康复中图分类号：Ｒ４７３．３　　文献标识码：Ａ　　文章编号：１００１-４１５２（２００７）０９-００５７-０２     

早期康复对重度偏瘫的脑卒中患者运动功能恢复的影响

目的：观察早期主动性康复治疗对重度偏瘫的脑卒中患者运动功能恢复的影响。方法：在沧州市两所二级医院选重度瘫痪的脑卒中偏瘫患者１０１例,康复组５７例,对照组４４便。在残损和残疾两个水平上评测患者功能。比较康复治疗后两组间的差异。结果：初次评测的各主要指标两组间无明显差别;末次评测的运动功能的ＦＭＡ上肢、ＦＭＡ下肢１、ＦＩＭ－ＡＤＬＳ、ＦＩＭ－Ｍｏｂｉｌｉｔｙ和ＦＩＭ每周增加值的结果,对照组分别为１１．     

早期康复护理干预对改善脑卒中病人ADL的探讨

目的探讨早期康复护理干预对急性脑卒中偏瘫患的运动功能、平衡功能、日常生活活动能力（ＡＤＬ）的影响。方法脑卒中偏瘫患６０例,对其中３０例患实施早期康复计划（康复组）,另外３０例人予神经内科一般治疗（对照组）。结果两组治疗前,治疗后一个月分别给予Ｆｕｇｌ－Ｍｅｙｅｒ评测法和ＦＩＭ评测法,对患肢体的残损程度和活动功能进行评定,经过统计学检验得出：治疗前评测,两组无明显差异（Ｐ＞０．０５）。治疗后     

早期康复干预对脑卒中患者日常生活活动能力的影响

目的：探讨早期康复治疗对脑卒中患日常生活活动能力（ＡＤＬ）的影响。方法：采用以Ｂｏｂａｔｈ为主神经促通技术分阶段有计划进行治疗性训练,治疗前后均采用Ｆｕｇｌ－Ｍｅｙｅｒ和Ｂａｔｈｅｌ评分。结果：康复组ＡＤＬ Ｂａｔｅｌ指数明显提高,与对照相比差异显。结论：早期康复干预可以明显提高急性脑卒中患ＡＤＬ和生存质量。     

早期强化训练对急性脑卒中患者生活自理能力的影响

目的：探讨早期强化训练对急性脑卒中患者生活自理能力的影响，方法；选择急性脑卒中的患者６５例，随机分为康复组及对照组，用前瞻性研究方法单盲评定，对两组进行对比分析，康复组在临床药物治疗的同时，１周内进行规定的康复训练，对照组给予临床治疗不经指导的自我锻炼，分别于第１～６周，３个月，６个月时评定，运动功能用Ｆｕｇｌ－Ｍｅｙｅｒ评分，ＡＤＬ用Ｂａｒｔｈｅｌ指数评分，神经缺损用神经功能损程度评分标准评分，     

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.