Calcium supplementation and prevention of preeclampsia: a meta-analysis

Background: Since the early 1980s, epidemiological evidence has suggested a connection between low calcium intake and preeclampsia The purpose of this meta-analysis is to summarize current evidence regarding calcium supplementation during pregnancy in predicting preeclampsia and associated maternal–fetal complications. Methods: Literature revision of all RCT (random allocation of calcium versus placebo) available in MEDLINE/PUBMED up to 2/29/2012 regarding calcium supplementation during pregnancy for preventing preeclampsia. We used the Mantel-Haenszel’s Method for four subgroup of patients: Adequate calcium intake; Low calcium intake; Low risk of preeclampsia; High risk of preeclampsia. We considered p < 0.05 as significant. Results: There is no consensus in Literature about: (1) the efficacy of calcium supplementation in the prevention of preeclampsia, (2) other/adverse/long-term effects of calcium supplementation in pregnancy. Conclusions: Preeclampsia is likely to be a multifactorial disease. However, inadequate calcium intake represents a factor associated with an increased incidence of hypertensive disease. The results of our meta-analysis demonstrate that the additional intake of calcium during pregnancy is an effective measure to reduce the incidence of preeclampsia, especially in populations at high risk of preeclampsia due to ethnicity, gender, age, high BMI and in those with low baseline calcium intake.     

老年吸入性肺炎患者早期纤维支气管镜吸痰的临床观察

目的观察早期纤维支气管镜吸痰用于老年吸入性肺炎的临床疗效,评价其实际应用价值。方法选择80例老年吸入性肺炎患者,随机分为观察组与对照组各40例,观察组采用早期纤维支气管镜吸痰进行治疗,对照组采用传统疗法进行治疗,对两组治疗后呼吸频率、心率、肺部湿罗音、影像学检查结果进行比较分析,观察组间是否存在统计学差异。结果应用早期纤维支气管镜吸痰治疗的观察组疗效明显优于使用传统疗法进行治疗的对照组,组间比较差异具有统计学意义(P<0.05)。结论早期纤维支气管镜吸痰治疗老年吸入性肺炎,疗效显著,值得临床推广应用。     

Nystagmus using video-oculography in psychiatric patients

To evaluate whether nystagmus has clinical significance in psychiatric patients who have functional and/or organic brain dysfunction. We performed gaze, positional and positioning nystagmus tests on 227 patients with psychiatric diseases (144 men, 83 women, with an average age ± SD of 62.5 ± 14.0 years) in order to evaluate the frequency and characteristics of nystagmus. Patients were classified according to the underlying disease. Normal control subjects were 107 subjects (26 men, 81 women, with an average age ± SD of 35.6 ± 10.0 years). Nystagmus was observed in 56 (24.7%) of 227 cases. Nystagmus was seen in 16 (59.3%) of 27 cases of alcoholism, 14 (22.2%) of 63 cases of organic psychiatric disorders, 25 (20.2%) of 124 cases of schizophrenia, 1 (20.0%) of 5 cases of excited mental retardation, 0 (0.0%) of 7 cases of mood disorders, 0 (0.0%) of 1 case of anxiety disorders and 1 (0.9%) of 107 subjects of normal control. There was a significant difference between psychiatric diseases and normal control. These results indicate that nystagmus may also be a very important clinical finding not only in patients with neurological and neuro-otological diseases, but also in patients with psychiatric diseases.     

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目的 了解唇腭裂患儿父母的心理状况,探讨影响唇腭裂患儿父母心理状况的相关因素.方法 采用标准化问卷对2008年9月至2010年5月福建医科大学附属协和医院口腔颌面外科收治的68例唇腭裂患儿的父母进行调查,以艾森克成人个性问卷(EPQ)评价其个性特征,以症状自评表(SCL-90)评价其自觉症状,并采用国内常模作为对照组进行对比分析.结果 唇腭裂惠儿的父母有其特殊的个性特征,存在着明显的心理问题.但父母之间心理状况无明显差异.结论 对唇腭裂患儿父母应采取积极的社会心理干预措施.     

经皮气管切开术在ICU的应用

目的探讨经皮气管切开术在ICU患者中的应用效果。方法对2008年1月～2010年6月我科气管切开的患者160例进行回顾性分析,其中96例采用经皮气管切开术作为研究组,64例采用传统气管切开术作为对照组。观察两组患者术中一般情况及主要并发症情况。结果研究组96例患者手术时间、术中出血量、切口大小及切口愈合时间明显优于对照组。两组数据间差异具有统计学意义（P〈0.05）。研究组并发症发生率为1.11%;对照组并发症发生率为25%,两组数据间差异具有统计学意义（P〈0.05）。结论经皮气管切开术手术操作简单,对患者创伤小,并发症发生率低,值得临床推广。     

气管插管危重症患者长途转运途中的呼吸道护理

随着急诊医学和急救护理学的迅速发展，各种急、危、伤、重症患者在各级医院间转诊、转运、途中监护抢救护理，已成为院前急救工作的重要组成部分，地区及县市的危重症患者常因诊断和治疗，需要到医疗水平和条件更好的大型综合医院进一步诊治。长途转运由于路途长、时间长，不可预见的各种意外，均会增加危重症患者的转运并发症，其中，尤以转运途中的呼吸道并发症多见。     

Bioelectric impedance phase angle is associated with hospital mortality of geriatric patients

Malnutrition is regularly associated with weight loss and changes in body composition, which lead to an increase in disability, complications and mortality. Bioelectric impedance analysis (BIA) is a simple and non-invasive bedside body composition analysis technique. In particular, bioelectric impedance phase angle (PA) has been shown to predict prognosis and mortality in several clinical conditions. The purpose of this study was to determine the relationship of BIA measurements and hospital mortality in multimorbid geriatric patients. The data obtained from the routine clinical admissions of 1071 consecutive patients (783 women and 288 men, age 81.4 ± 8.5 years) to a geriatric hospital unit was analyzed retrospectively. A significant difference of PA (50 kHz) between survivors (4.2 ± 1.1°) and non-survivors (3.6 ± 1.2°; p < 0.001) of the hospital stay could be detected. Subjects with a PA below 3.5° showed a significant fourfold increased hospital mortality of 20% (95% CI = 15-24%) compared to all other subjects (5%; 95% CI = 4-7%). No calculated parameters of BIA reflecting body composition were associated with hospital mortality. Although the extent to which the PA may be regarded as a marker of nutritional state is still controversial, it was associated with hospital mortality in geriatric patients.     

成批煤矿瓦斯爆炸伤的院前急救

目的探讨院前急救对成批煤矿瓦斯爆炸伤患者的作用。方法对我院收治的7起瓦斯爆炸烧伤27例患者实施院前急救。结果 27例患者严格实施院前急救流程,包括电话接诊、静脉输液、观察病情、早期正确的现场处理等。经现场急救后全部患者在8 min~32 min安全转入烧伤专科病房,经过及时有效的专科治疗,27例患者中6例死亡,其余患者于伤后16 d~93 d出院。结论实施规范、科学的院前急救是抢救瓦斯爆炸成批烧伤患者的关键,对入院后的救治具有重要意义。     

The forgotten caregivers: Siblings of schizophrenic patients

Objective. The situation of caregivers of psychiatric patients is mostly focussed on burdens of parents or spouses of patients. The burden of siblings due to the illness, however, is mostly underestimated and disregarded. Methods. Thirty-seven narrative interviews with siblings of schizophrenia inpatients were analysed by using a summarizing content analysis. The founded global statements were quantitatively analysed. Regression-analysis as well as regression trees were used to evaluate the data linked with sociodemographic and disease-related variables of the patient and siblings. Results. The results showed a high proportion of siblings engaged in caregiving activities. A total of 492 individual statements were summarized in 26 global types of statements. The three most often reported burdens by the healthy siblings are: “Handling the symptoms of illness” (100%), “Emotional burden due to the illness of the sibling” (100%) and “Uncertainty in judging what amount of stress the patient can cope with” (81.1%). Linear regression and regression tree analysis show predictors for higher burdened siblings. Conclusion. Siblings of schizophrenia patients are burdened in various aspects and in a specific matter. Their special needs will therefore have to be recognised before they can receive appropriate intervention.