Medico legal investigations into sudden sniffing deaths linked with trichloroethylene

Sudden deaths attributed to sniffing trichloroethylene are caused by the abuse of this solvent which produces pleasant inebriating effects with rapid dissipation. In the event of repeated cycles of inhalation, a dangerous and uncontrolled systemic accumulation of trichloroethylene may occur, followed by central nervous system depression, coma and lethal cardiorespiratory arrest.Sometimes death occurs outside the hospital environment, without medical intervention or witnesses and without specific necroscopic signs.Medico legal investigations into sudden sniffing deaths associated with trichloroethylene demand careful analysis of the death scene and related circumstances, a detailed understanding of the deceased's medical history and background of substance abuse and an accurate evaluation of all autopsy and laboratory data, with close cooperation between the judiciary, coroners and toxicologists.     

突发性聋患者负性情绪知信行模式构建及应用效果

目的 探讨知信行模式在突发性耳聋患者中的应用效果。 方法 应用随机数字表法将2017年1月至2018年6月收治的68例突发性耳聋患者分为A组和B组各34例,A组接受常规护理模式指导下护理干预,B组接受知信行模式指导下护理干预,采用自编量表、Zung氏焦虑自评量表、Zung氏抑郁自评量表问卷分别于入组时和3个月进行调查。比较两组患者护理满意度、焦虑情绪和抑郁情绪变化。 结果 干预3个月后,B组和A组患者Zung氏焦虑自评量表标准分、Zung氏抑郁自评量表标准分均优于入组时(t分别为26.994、37.554,P均<0.001),B组Zung氏焦虑自评量表标准分、Zung氏抑郁自评量表标准分低于A组(t分别为12.769、10.040,P均<0.001)。B组患者护士与患者沟通能力、护理行为规范性、护士解决患者问题能力、护士为患者健康宣教的能力优于A组(t分别为15.285、19.263、15.757、15.096,P均<0.001)。 结论 构建的知信行模式能改善突发性聋患者负性情绪,提高患者的护理满意度。     

Sudden sensorineural hearing loss during pregnancy: clinical characteristics,management and outcome

Background: Sudden sensorineural hearing loss (SSNHL) may occur during pregnancy with a rare prevalence, and little is known about it.

Aims: To retrospectively analyze cases of SSNHL during pregnancy and investigate their clinical characteristics, management and outcome.

Material and methods: Records of 30 SSNHL patients during pregnancy were reviewed, including age, localization, duration from onset to treatment, gestation period, accompanying symptoms, initial hearing threshold, final hearing threshold, audiogram, treatment and outcome.

Results: Twenty-four patients (80.0%) suffered SSNHL in the second trimester or the last trimester with a high rate of tinnitus (70.0%). The initial hearing threshold was 63.4?±?25.1?dB, and most audiograms were flat and profound. The overall recovery rate was 60.0%, including complete recovery (33.3%) and partial recovery (26.7%). Further, 16 patients received adjuvant intratympanic steroid showed a better audiologic outcome (improvement 27.1?±?16.4 vs. 15.7?±?12.0?dB, p?=?.042) than those who had not.

Conclusions and significance: SSNHL during pregnancy often occurred in the second trimester or the last trimester with a severe hearing loss, the most audiogram configurations are flat and profound. Dextran-40 is a safe and beneficial therapy for SSNHL patients during pregnancy and adjuvant intratympanic steroid increase the probability of hearing recovery.