初发老年脑梗死患者康复自理能力观察

目的：为预测初发老年脑梗死住院患出院时的自理能力，方法：采用回顾性分析的方法对初发脑梗死患去除入院时能独立步行及死亡的病例，剩余按出院时的生活能否自理而分为自理组和非自理组，对发病时的情况，入院后第1次的各种检查结果及康复治疗等参数进行单张多元回归分析，结果：单因素分析中，两组间差异有显性＊P＜0．05），多元回归分析发现8个因素与患生活自理能力有相关性（P＝0．001－0．056），结论：根据发病及入院时的相关参数可以预测出院时的生活自理能力，并为拟定早期康复计划提供客观依据。     

脑出血病人有关生活自理能力预测研究

目的预测初发脑出血住院病人出院时有关生活自理能力。方法１６０例初发脑出血住院病人,男８６例,女７４例,平均年龄６１．０±１７．４３岁,以出院时生活能否自理分为自理组和非自理组,对发病情况、入院后各种检查等参数用单因素（ｔ和χ２检验）和多因素（多元回归）分析。结果２组在性别、年龄、发病至入院时间和住院天数等方面无显著性差异。单因素分析１６个变量（Ｐ＜０．０１）;多因素分析９个变量对预后有显著性意义（Ｐ＝０．０９７－０．００３）。结论影响初发脑出血住院病人出院时生活自理能力的因素主要为发病时有高血压和心脏病史,入院时有肢体瘫痪、失语、尿失禁、肺部感染,入院后开颅手术,出血量和出血半球等。研究结果对筛选脑出血病人早期康复治疗具有指导作用。     

初发老年脑梗死患者康复自理能力观察

目的为预测初发老年脑梗死住院患者出院时的自理能力。方法采用回顾性分析的方法对初发脑梗死患者去除入院时能独立步行及死亡的病例,剩余按出院时的生活能否自理而分为自理组和非自理组。对发病时的情况,入院后第1次的各种检查结果及康复治疗等参数进行单因素和多元回归分析。结果单因素分析中,两组间差异有显著性(P<0.05);多元回归分析发现8个因素与患者生活自理能力有相关性(P="0.001～"0.056)。结论根据发病及入院时的相关参数可以预测出院时的生活自理能力,并为拟定早期康复计划提供客观依据。<P>     

初发老年脑梗死患者生活自理能力预测研究

为预测初发老年脑梗死住院患者出院时的生活自理能力,采用回顾性分析的方法对１９９１～１９９４年年龄〉６０岁的初发脑梗死患者共２４２例,去除入院时能独立步行（９０例）及住院期间死亡（１３例）的病人,剩余１３９例按出院时的生活能否自理而分为自理组（５６例）和非自理组（８３例）。对发病时的情况,入院后第１次的各种检查结果以及康复治疗等参数进行单因素（ｔ和ｘ＾２检验）和多元回是分析。结果 单因素分析中,血糖     

初发脑梗塞患者步行能力的预测研究

目的：预测初发脑梗塞信院患出院时的步行能力。方法：回顾性分析１９９１～１９９４年住院的初发脑梗塞患,共３６０例（１４例死亡）,２０４例入院时不能行走,按出院时能否独立行走分为行走组（９５例）和非行走组（１０９例）。对发病时情况,入院后检查结果等参数进行单因素（ｔ检验和χ＾２）检验和多元回归分析。结果：单因素分析中年龄、高血压、糖尿病、尿失禁、大片梗塞及及住院天数２组间差异有显性（Ｐ〈０．０５     

初发脑梗塞患者步行能力的预测研究

目的预测初发脑梗塞住院患者出院时的步行能力.方法回顾性分析1991～1994年住院的初发脑梗塞患者,共360例(14例死亡),204例入院时不能行走,按出院时能否独立行走分为行走组(95例)和非行走组(109例).对发病时情况,入院后检查结果等参数进行单因素(t检验和x2检验)和多元回归分析.结果单因素分析中年龄、高血压、糖尿病、尿失禁、大片梗塞及住院天数2组间差异有显著性(P＜0.05);多因素分析中年龄、性别、失语、头晕、住院天数、入院时血压、糖尿病、冠心病、病灶所在半球、大片、多发梗塞、血尿素氮、尿白细胞等14个因素对步行能力有显著性影响(P=0.01～0.05).结论根据初发脑梗塞患者发病及入院时的资料可以预测出院时的步行能力,并为拟定早期康复计划提供客观依据.     

初发老年脑梗死患者生活自理能力预测研究

为预测初发老年脑梗死住院患者出院时的生活自理能力,采用回顾性分析的方法对1991～1994年住院的年龄＞60岁的初发脑梗死患者共242例,去除入院时能独立步行(90例)及住院期间死亡(13例)的病例,剩余139例按出院时的生活能否自理而分为自理组(56例)和非自理组(83例)。对发病时的情况,入院后第1次的各种检查结果以及康复治疗等参数进行单因素(t和χ     

初发急性脑卒中患者出院步行能力预测研究

目的：根据发病及入院时资料预测初发急性脑卒中患者出院时的步行能力。方法：回顾性分析524例初发急性脑卒中患者，42例住院期间死亡，482例生存者中，173例入院时可以行走，309例不能行走，根据309例患者出院时能否步行，将其分为步行组（n=164例）和非步行组（n=145)，收集的资料包括病史、入院时体格检查，第一次生化和心电图检查，对收集的资料采用单因素方差分析和多元回归分析。结果：单因素分析发现，2组在年龄，中风类型，糖尿病病史，入院时的神志，肢体瘫痪，尿失禁，肺部感染，血糖及尿素氮水平之间的差异有非常显著性和显著性意义（P=0.0005-0.0200)，多元回归分析发现，年龄，脑卒中类型，糖尿病史、入院时尿失禁及明显的肢体瘫痪是预测出院时能否行走的可靠因子（P＝0．0005－0．041），结论：初发脑卒中患者发病及入院时的资料可以用来预测患者出院时的步行能力，研究结果也可以作为筛选早期康复对象的依据。     

脑卒中患者生活自理能力预测研究

目的 预测初发脑卒中患今后生活自理能力。方法 回顾性分析１９７例初发脑卒中中层得，以Ｂａｒｈｅｌ指数评定生活自理能力。按得分多少分为自理组（ＢＩ≥６１分）１２３例，非自理组（ＢＩ≤６０分）７４例，对发病时情况，入院后第１次各项检查结果以及康复治疗等参数进行单因素（ｔ和Ｘ＾２检验）和多元回归分析。结果 单因素分析中，合并多种疾病，入院时神志，认知障碍，尿失禁，肺部感染，高血糖，失语，脑部病灶大小，     

Orem 自理模式在慢性肺源性心脏病患者中的应用效果观察

目的：探讨Orem自理模式对慢性肺源性心脏病患者生活质量的影响。方法将100例慢性肺源性心脏病患者随机分为观察组（50例）和对照组（50例）,观察组采用Orem自理模式护理,对照组采用常规护理。出院时采用生活自理能力（ADL）评价量表对两组进行效果评价。结果干预前两组ADL评分、自理能力、疾病知识缺乏程度无显著性差异（ P＞0．05）。干预后观察组ADL评分、自理能力、疾病知识掌握情况均优于对照组（P ＜0．05或0．01）。结论 Orem自理模式能显著提高慢性肺源性心脏病患者的生活质量。     

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.     

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.     

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.