BNP concentrations and cardiovascular adaptation in preterm and fullterm newborn infants

To evaluate and compare cardiovascular adaptation of 36 preterm and 34 fullterm newborns, we analyzed BNP concentration and echocardiographic parameters at day 3 of life and at day 28 (± 2). On day 3 BNP concentrations (pg/ml) resulted higher in PDA preterm group (n = 11; 125, IQR 56.1-301) than preterm without PDA (n = 25; 25.5 IQR 10.9-49; p < 0.001) than fullterms (n = 34; 55.1 IQR 23.6-82.7; p = 0.013). No difference resulted in all groups at 28 days (respectively: 12.7 IQR 4.9-23.8; 15.6 IQR 10-22; 8.9 IQR 5.6-20.6). Because of the newborns' growth, all echocardiographic parameters increased with linear relationship with body weight. On day 3 BNP concentration and echocardiographic parameters were not correlated besides LA/AO in preterms with PDA (p = 0.0015). On day 28, BNP was significantly correlated with mVTI (p = 0.019), M (p = 0.007) and LA (p = 0.005) in fullterms and only with LA (p = 0.007) in preterms.In conclusion, BNP concentrations and echocardiographic measures confirm that preterm, and fullterm newborns conduct themselves in a similar manner during the transition from foetal to post-natal circulation, reaching low levels at a month of life. The presence of PDA during first days of life has no significant impact in this adaptation. LA is the echocardiographic parameter mostly related to BNP concentration in the newborns.     

移动护理信息系统在我国护理管理中的应用

移动护理信息系统的建立和应用不仅改变了传统的临床护理工作模式,同时给护理管理者带来更先进、便捷、全面的管理模式。对移动护理信息系统在我国的应用现状、特点及所面对的挑战逐一进行阐述。     

基于二维条码和移动技术的医疗设备管理系统的设计与开发

目的开发医院设备管理系统,提高设备资产管理工作的质量和效率。方法业、地方医疗器械编码标准,借助二维条码和移动技术开发一套符合医院设备管理统。结果本系统的使用,提升了医院整体管理水平。结论该系统实现了国有资产合理利用。结合国家、行需的信息系的规范管理、     

移动护士站的开发与应用

目的为完整准确地记录患者信息,辅助医护人员高效、安全、方便地核对病人信息,精确反映治疗过程,开发移动护士站,实现医院信息系统（HIS）从以管理为中心向以病人为中心的临床信息系统（CIS）转变。方法在病区内架设无线网络,医护人员通过手持移动设备,配合患者腕带,随时查阅病人信息,并可以随时随地对信息进行核对及补充。结果移动护士站辅助护士高效完成床边操作,减少医疗过程中的人为失误,提高了护理工作的质量和效率。结论移动护士站是HIS向病房内的扩充和延伸,优化了护理过程。     

Chromatographic determination of drugs of abuse in vitreous humor using solid‐phase extraction

A simple method is presented for the simultaneous determination of morphine, 6‐acetylmorphine, codeine, cocaine, benzoylecgonine, cocaethylene, methadone and 2‐ethylidene‐1,5‐dimethyl‐3,3‐diphenylpyrrolidine (EDDP) in vitreous humor by high‐performance liquid chromatography with photodiode array detector after solid‐phase extraction with Oasis® HLB cartridges and dichloromethane as eluent. The chromatographic process was carried out using an XTerra® RP8 column (250 × 4.6 mm i.d., 5 µm particle size) and a mobile phase composed of acetonitrile and pH 6.5 phosphate buffer in gradient mode. A linear response from the detector was obtained within the concentration range of 0.1–4 µg ml^?1, with correlation coefficients higher than 0.99. The limits of detection were lower than 30 ng ml^?1 for all the drugs studied, the coefficients of variation fluctuated between 0.1 and 12.4%, and the average recoveries were higher than 78% for all the drugs except for EDDP, with a value of 66.4%. Finally, the proposed method was applied to 15 vitreous humor samples coming from individuals who had died from opiate and/or cocaine overdose, showing consumption of cocaine in 14 cases, methadone in five cases and heroin in three cases. Average concentrations of 0.30 µg ml^?1 for morphine, 0.24 µg ml^?1 for 6‐acetylmorphine, 0.10 µg ml^?1 for codeine, 0.81 µg ml^?1 for cocaine, 1.26 µg ml^?1 for benzoylecgonine, 0.15 µg ml^?1 for cocaethylene, 0.11 µg ml^?1 for methadone and 0.68 µg ml^?1 for EDDP were obtained. Copyright © 2012 John Wiley & Sons, Ltd.     

Pharmacological characterization and chemical fractionation of a liposterolic extract of saw palmetto (Serenoa repens): Effects on rat prostate contractility

Ethnopharmacological relevance

Saw palmetto (Serenoa repens) was first used medicinally by native American Indians to treat urological disorders. Nowadays, saw palmetto extracts are widely used in Europe and North America to treat the urinary symptoms associated with benign prostatic hyperplasia even though its mechanisms of action are poorly understood. This study aimed to characterize the bioactive constituents of a lipid extract of saw palmetto that are able to affect contractility of the rat prostate gland. The mechanism of action will also be investigated.

Materials and methods

A commercially available lipid extract of saw palmetto was subjected to fractionation using normal phase column chromatography. Composition of fractions was assessed by proton nuclear magnetic resonance spectroscopy (¹H NMR) and mass spectrometry (MS). Contractile activities of these fractions were evaluated pharmacologically using isolated preparations of rat prostate gland and compared to the activity of the crude extract.

Results

Saw palmetto extract inhibited contractions of the rat prostate gland which were consistent with smooth muscle relaxant activity. Only the ethyl acetate fraction resulting from chromatography inhibited contractions of isolated rat prostates similarly to the inhibition produced by the crude lipid extract. Comparison with authentic samples and analysis of NMR data revealed that this bioactivity was due to the fatty acid components present in the ethyl acetate fraction. Bioassay using various pharmacological tools identified multiple contractile mechanisms which were affected by the bioactive constituents.

Conclusion

A fatty acid component of saw palmetto extract causes inhibition of prostatic smooth muscle contractions via a non-specific mechanism.     

Randomized controlled trial of an internet-based versus face-to-face dyspnea self-management program for patients with chronic obstructive pulmonary disease: pilot study

Background

People with chronic obstructive pulmonary disease (COPD) continue to experience dyspnea with activities of daily living (ADL) despite optimal medical management. Information and communication technologies may facilitate collaborative symptom management and could potentially increase the reach of such interventions to those who are unable to attend face-to-face pulmonary rehabilitation or self-management programs.

Objective

The purpose of this randomized study was to test the efficacy of two 6-month dyspnea self-management programs, Internet-based (eDSMP) and face-to-face (fDSMP), on dyspnea with ADL in people living with COPD.

Methods

We randomly assigned 50 participants with moderate to severe COPD who were current Internet users to either the eDSMP (n = 26) or fDSMP (n = 24) group. The content of the two programs was similar, focusing on education, skills training, and ongoing support for dyspnea self-management, including independent exercise. The only difference was the mode (Internet/personal digital assistant [PDA] or face-to-face) in which the education sessions, reinforcement contacts, and peer interactions took place. Participants returned to one of two academic clinical sites for evaluation at 3 and 6 months. The primary outcome of dyspnea with ADL was measured with the Chronic Respiratory Questionnaire. Secondary outcomes of exercise behavior, exercise performance, COPD exacerbations, and mediators, such as self-efficacy and social support, were also measured. A satisfaction survey was administered and a semistructured exit interview was conducted at the final visit.

Results

The study was stopped early due to multiple technical challenges with the eDSMP, but follow-up was completed on all enrolled participants. Data were available for 39 participants who completed the study (female: 44%; age: 69.5 ± 8.5 years; percent predicted forced expiratory volume in 1 s: 49.6 ± 17.0%). The fDSMP and eDSMP showed similar clinically meaningful changes in dyspnea with ADL from baseline to 3 months (fDSMP: + 3.3 points; eDSMP: + 3.5 points) and sustained these improvements at 6 months (fDSMP: + 4.0 points; eDSMP: + 2.5 points; time effects P < .001; group by time P = .51). Self-reported endurance exercise time (P = .001), physical functioning (P = .04), and self-efficacy for managing dyspnea (P = .02) also showed positive improvements over time in both groups with no significant differences with respect to program modality. Participants who completed the study reported favorable satisfaction with the programs.

Conclusions

Although there were numerous technical challenges with the eDSMP, both dyspnea self-management programs were effective in reducing dyspnea with ADL in the short term. Our findings will need to be confirmed in a larger randomized trial with more mature Web and personal digital assistant tools, use of a control group, and longer follow-up.

Trial registration

clinicaltrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00102401","term_id":"NCT00102401"}}NCT00102401, http://www.webcitation.org/5X8CX4gLC     

动脉导管未闭单病种临床路径的成本管理

目的 探讨单病种临床路径管理对动脉导管未闭(patent ductus arteriosus,PDA)患儿的住院时间和费用的影响,以制定合理的病种费用控制体系,加强病种质量管理和病种费用控制.方法 选择2007年2月至2010年6月住院的PDA患儿共112名,按住院单双日分为常规治疗组52例,临床路径组60例.常规治...     

下颌骨髁突骨折年龄和特点分析

目的探讨下颌骨髁状突骨折的发生特点与发病年龄的关系.方法对356例髁状突骨折病例的发生年龄、性别、致伤原因、骨折类型、合併伤等进行分析.结果髁状突骨折好发于20～30岁;男性多于女性,交通事故伤（46.91%）为主要致伤原因;按位置、移位和年龄分型共分为Ⅰ型223侧、Ⅱ71侧、Ⅲ三型149侧;61.24%合并颏部骨折.结论髁状突骨折中男性好发,交通事故是主要原因,年龄、致伤原因与骨折部位、移位相关.