Menopausal symptoms following breast cancer treatment: A qualitative investigation of cognitive and behavioural responses

Objectives

Menopausal symptoms – hot flushes and night sweats (HF/NS) – are particularly troublesome for women who have undergone breast cancer treatment. Non-medical treatments, such as cognitive behaviour therapy, are being developed but there is a lack of information about cognitive and behavioural reactions to HF/NS in breast cancer patients.

Methods

Thirty-five women who had completed active breast cancer treatment with at least 10 HF/NS per week completed questionnaires assessing HF/NS, mood and beliefs, and took part in interviews to elicit cognitive and behavioural reactions and a thematic content analysis used to analyse the data.

Results

The mean weekly frequency of HF/NS was 76 (SD = 46) (57 HF and 19 NS). Smokers reported significantly more night sweats, but BMI and mood were not associated with HF/NS frequency. Cognitive and behavioural responses were varied but broadly similar to those of well women. The main cognitive themes were: embarrassment/social anxiety, loss of control, beliefs about NS, sleep and tiredness, and the main behaviours were: carry on and ignore them, cool down, avoidance, communication with others.

Conclusions

The results are discussed within a cognitive behavioural framework and might inform the development of psychological interventions for these treatment related symptoms.     

手部热压伤后临床治疗

目的 总结38例手部热压伤创面治疗方法选择的临床体会.方法 对38例手部热压伤患者,根据临床伤情特点使用相应的治疗方法.结果 33例皮瓣手部功能完全或部分恢复,5例无功能.结论 根据不同外伤程度、部位,选择适当的治疗方法是手部热压伤治疗的关键.适合的治疗可以确保手部最大程度的功能恢复.     

上腹部热敷对全麻妇科腹腔镜手术后患者恶心呕吐发生率的影响

目的探讨上腹部热敷对术后恶心呕吐（PONV）发生率的影响。方法选择100例ASA1—2级、在气管插管全身麻醉下行妇科腹腔镜手术患者,随机分为对照组（C组）与热敷组（H组）,每组50例。H组在术后用热水袋热敷上腹部6～8h,C组不作任何处理。观察术后24h恶心、呕吐发生率。结果C组与H组恶心发生率分别为42．0％、22．0％,H组显著低于C组（P〈0．05）;C组与H组呕吐发生率分别为18．0％、12．0％,两组间比较无显著性差异（P〉0．05）。结论术后早期上腹部热敷可有效降低术后恶心的发生率,作为一个辅助防治措施,有一定的临床应用价值。但它不能完全消除PONV的发生,且不能降低呕吐的发生率。     

浅析急性鼻窦炎的治疗

目的了解急性鼻窦炎的临床特点和临床治疗。方法通过药物疗法和物理疗法治疗急性鼻窦炎。结果局部血液循环正常,白细胞增多,鼻吸正常。结论常规下急性鼻窦炎的局部用药治疗加上物理治疗效果显著。     

锚定法改良单开门颈椎管成形术配合中药热敷防治术后轴性症状的疗效观察

单开门颈椎管扩大成形术是用于治疗多节段退变的脊髓型颈椎病、颈椎后纵韧带骨化症、无骨折脱位型颈脊髓损伤等颈椎疾患的经典术式,在解除脊髓压迫、改善神经功能方面具有确切而持久的疗效。但也常常伴有术后颈椎总活动度明显减少,同时还常常伴有颈部慢性疼痛、僵硬感、沉重感,亦即轴性症状,而轴性症状与术后颈椎活动度减少呈正相关。笔者应用锚定法改良单开门颈椎管扩大成形术配合中药热敷治疗脊髓型颈椎病、无骨折脱位性颈脊髓损伤等疾患,以防治颈椎管成形术后轴性症状的发生,疗效满意,现报告如下。     

厚朴加粗盐热熨腹部缓解腹胀症状的护理体会

腹胀是临床上最常见的症状之一，厚朴是我国传统芳香化湿中药，主治食积气滞、腹胀便秘，湿阻中焦，运用厚朴加粗盐热熨腹部缓解腹胀效果显著。     

温度和时间对10%葡萄糖注射液中5-羟甲基糠醛含量的影响

10% 葡萄糖注射液中5- 羟甲基糠醛含量随温度、时间而改变。初均速法加速实验,以ln Vol,代替InKi对热力学温度的倒数1/T1作Arrhenius图得直线,线性回归计算出反应活化能和不同温度下5一羟甲基糠醛含量的达限时间。结果提示;在制剂灭菌,药品使用和贮存过程中,应采用科学的,适宜的方法和措施,确保药品质量。     

Changes in blood-brain barrier permeability during hot water-induced seizures in rats

Abstract. Hot water epilepsy (HWE) was induced in freely moving Wistar rats by applying hot water jets over the head region. The status of the blood-brain barrier (BBB) during the seizures and during hot water-induced hyperthermia without seizures was examined using Evans blue dye. In order to investigate the contribution of concomitant factors to this process, synchronized body temperature and blood pressure recordings were also made. Tonic-clonic seizure activity was observed within an average of 3.9 min (SE=0.6 min) in the rats exposed to the hot water jets; this treatment induced BBB opening in the cortical and deep brain areas. Body temperature and blood pressure increased from 36.5°±0.3°C to 40.0°±0.2°C, and from 91±3 mmHg to 153±4 mmHg, respectively. In the group of animals exposed to hot water application without inducing seizures, there were significant increases both in blood pressure and body temperature; however, the extravasation of Evans blue was not pronounced in the brains. Hot water-induced seizures, increased cerebrovascular permeability. Although high blood pressure and hyperthermia contribute to this permeability, the seizure activity is the major factor in this change.     

Isoflavones--safe food additives or dangerous drugs?

The sales volume of products containing isoflavone has increased since the publication of the Women's Health Initiative. The many apparently contradictory results published on the effects of isoflavones on a variety of estrogen-regulated organs point to both beneficial as well as adverse effects on human health. It is of particular importance that psychovegetative climacteric complaints such as hot flushes are, if at all, only slightly influenced by isoflavones. The substances appear to have weak anti-osteoporotic effect. Their anti-atherosclerotic action is debatable, as not all authors find any beneficial effect on lipids. Most importantly, there is dispute as to whether isoflavones derived from soy or red clover have negative, positive or any effect at all on the mammary gland or endometrium. It is beyond any doubt that soy products may have cancer preventing properties in a variety of organs including the mammary gland. However, these properties may only be exerted if the developing organ was under the influence of isoflavones during childhood and puberty. This may also explain the often quoted "Japanese Phenomenon", the fact that breast cancer occurs to a lesser extent in Japanese women. When administered to isoflavone "inexperienced" women at the time of menopause, the phytoestrogens appear to share the same effects as estrogen used in classical preparations for hormone replacement therapy, i.e. they may stimulate the proliferation of endometrial and mammary gland tissue with at present unknown and unpredictable risk to these organs. Therefore, the following question arises for the clinician: Why should soy or red clover products containing isoflavone be recommended, if the positive effects are only negligible but the adverse effects serious?     

Do hot spots of deprivation predict the rates of suicide within London boroughs?

INTRODUCTION: The ecological associations between suicide rates and different indices of deprivation within London have been investigated at least for half a century. In the present study, the association between rates of suicide with newly developed hot spots of deprivation index within London boroughs have been studied taking into account the results of the spatial dependency between suicide rates in nearby boroughs. METHODS: Suicide data were provided by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. The hot spots index of deprivation and the population counts were provided by the Department of the Environment, Transport and the Region (DETR) and Office for the National Statistics (ONS), respectively. RESULTS: The results show that there is no strong spatial dependency between suicide rates in the London boroughs, the 'hot spots' index of deprivation predicts the rates of suicide in males 30-49, better than other age and sex groups. The rate of suicide decreases with decreasing deprivation as indicated by the 'hot spots' index. CONCLUSION: These findings suggest that at the London boroughs the 'hot spots' index of deprivation (together with other socio-economic and social fragmentation indices) should be considered as a potential explanatory variable to explain the effects of age on rates of suicide in men and women.