Patient compliance with Hawley retainers fitted with the SMART® sensor: A prospective clinical pilot study

Objective:To evaluate the compliance of patients while wearing maxillary Hawley retainers embedded with SMART microsensors.Methods:The sample population consisted of 22 patients who were divided into an experimental (group A) and a control group (group B). Group A was informed that they would be monitored through the use of SMART microsensors, while group B was not informed that they would be monitored. After the delivery of the retainers (T0), the patients were evaluated at T1 and T2, represented by 6- and 12-week follow-up visits, respectively. At T1, group B was informed of our ability to monitor their compliance. Both groups continued wearing their retainers during T1 to T2.Results:During T0–T1, Group A wore their retainers for an average of 16.3 hours (SD 4.39), while group B wore their appliances for an average of 10.6 hours (SD 5.36, t  =  2.426, P  =  .027). Although group B increased their retainer wear by 0.5 hours/day from T1 to T2, this increase was not statistically significant.Conclusions:Despite significant differences being noted between the two groups at T1, group B did not show significant mean changes in their wear time before and after becoming aware of the use of the SMART microsensor.     

护理技术操作中标准预防的执行情况调查

目的探讨分析护理技术操作中执行标准预防的情况。方法采用操作考核与现场观察对4所医院的122名护理人员在技术操作中执行标准预防的情况进行调查;采用问卷调查157名来自5个省份的护理实习生对标准预防的认识。结果操作考核中的洗手和戴手套环节被忽略,职业暴露保护没有纳入操作流程;在临床操作中手卫生和戴手套的执行率低,戴手套仍未引起护理人员的重视,包括护理教师,不便于操作是戴手套依从性低的主要原因;在连续操作之间采用快速手消毒剂(ABHR)洗手具有可行性。结论从学校做起、从岗前培训抓起,应在护理技术操作制度和细节上体现标准预防,具体到"六步洗手法"和戴手套等,以提高执行的法规性;应让学生戴手套进行相关的操作练习,以提高执行的适应性。     

薇诺娜舒敏保湿特护霜对新冠疫情防控期间医护人员佩戴医用口罩后皮肤屏障的修复

目的观察使用薇诺娜舒敏保湿特护霜对疫情期间医护人员佩戴医用口罩后皮肤屏障修复作用及皮肤敏感改善情况。方法采用自身前后对照研究,选取受试者佩戴口罩后的右侧面颊为受试区。入组当天晨起及佩戴口罩4 h后检测经表皮水分流失(transepidermal waterloss,TEWL)及角质层含水量,随后发放受试品(薇诺娜舒敏保湿特护霜),每日清洁皮肤后早晚各1次外搽受试品于受试者面颊,连续使用14 d。分别在第7天及第14天佩戴口罩4 h后再次检测TEWL及角质层含水量,进行疗效及安全性评估。结果皮肤生理功能测试结果显示,使用薇诺娜舒敏保湿特护霜干预后,TEWL入组后第7天及第14天较基础值、入组前显著降低,差异有统计学意义(P<0.05);佩戴口罩4 h后9.57%~31.91%的受试者出现了不同程度的皮肤敏感症状,外捈薇诺娜舒敏保湿特护霜后60.64%受试者自觉皮肤敏感症状得到改善。结论外搽薇诺娜舒敏保湿特护霜可有效保护疫情期间长期佩戴医用口罩的医护人员的皮肤屏障功能,同时改善皮肤敏感情况。     

Plantar pressure distribution and wearing characteristics of three forefoot offloading shoes in healthy adult subjects

Forefoot offloading shoes are used to reduce pressure on specific regions of the foot. Aim of the pressure reduction is to aid healing of the soft and bony tissues and prevent complications by treating foot disorders. A great variety of forefoot offloading shoes are available. In a first step to investigate the appropriate use of these footwear in orthopedic settings, we studied plantar pressure distribution and wearing characteristics of three forefoot offloading shoes namely the Mailand, OrthoWedge and Podalux in a healthy population.Twenty subjects walked in a randomized order wearing three forefoot offloading shoes and a reference shoe for six minutes. The Pedar system was used to measure the pressure in 7 regions. Peak pressure and pressure time integral were analyzed as measures of pressure distribution. Furthermore, wearing characteristics were addressed using a Numeric Rating Scale. Pressure distribution and wearing characteristics of the forefoot offloading shoes were compared to a reference shoe.The Mailand and OrthoWedge shoes significantly reduced peak pressure with more than 80% under the hallux and more than 45% under MTH1 (p < .001). The Podalux did not show significant peak pressure reduction under the forefoot compared to the reference shoe. Under the lesser toes, the MTH4-5 region and heel region the Podalux shoe showed even a significant increase in peak pressure (p = .001). Looking at wearing characteristics, the Podalux and reference shoe scored significantly better than the other two forefoot offloading shoes (p < .01).In this study the differences between different forefoot offloading shoes was assessed. The Mailand and OrthoWedge shoes gave the best pressure reduction in the forefoot but are less comfortable in use. The Podalux rocker shoe showed opposite results. Next step is a patient study to compare our results in a patient population.     

A validation study of the Chinese wearing off questionnaire 9-symptom for Parkinson's disease

Objective

Development of wearing off (WO) often goes unnoticed for both patients with Parkinson's disease (PD) and physicians due to the complexity of this phenomenon. A brief 9-symptom WO questionnaire (WOQ-9) was recently found to be highly sensitive in its detection. We aimed to validate a Chinese version WOQ-9 (CWOQ-9) among Chinese patients with PD.

Methods

We recruited 101 literate Chinese PD patients among 4 different neurology or movement disorders clinics in Hong Kong to participate in this study by completing the CWOQ-9. Clinical judgment by the specialists was considered the gold standard for diagnosing WO.

Results

The mean age (±SD) of the patients was 61 (±9) years and 35 (34.7%) of them were female. The disease duration was 7.4 (±5.4) years and 69 (68.3%) of them were diagnosed clinically to have WO by the specialists. The positive and negative predictive values, sensitivity and specificity of CWOQ-9 were 86%, 71%, 87%, and 69% respectively. The area under curve (AUC) was 0.78 (p < 0.001).

Conclusion

This simple patient questionnaire is a valid tool for the detection of WO among Chinese PD patients.     

Knee joint angle sensing in healthy young adults using flexible orthosis with different wearing pressure

[Purpose] To investigate the effects of a flexible brace, by analyzing whether its usage; the difference in wearing pressure could change the joint position sensation in healthy participants; and develop a flexible knee brace for patients with knee osteoarthritis. [Participants and Methods] The study included eight healthy males with 14 knee joints (mean age, 22.0 ± 3.1 years). To measure joint position sense, an “angle reproduction test” was performed in three experimental conditions: 1) participants not wearing the brace, 2) the brace was secured with an appropriate force, and 3) the brace was fully secured using hook-and-loop fasteners. [Results] No significant difference was observed among groups comprising of those not wearing, those wearing with the standard force, and those wearing with the tight force. When the maximum hook-and-loop fastener was squeezed, the sensory error in joint position was maximized at both 30° and 60° flexion. [Conclusion] Joint position sense improvement was confirmed to be poor by orthosis, and an error occurred in the joint position sense by increasing the wearing pressure in orthosis. In future, measurements should be performed on patients with knee osteoarthritis who have decreased joint position sense and verify the effect of different wearing pressures verified.     

Effects of an over-ground exoskeleton on external knee moments during stance phase of gait in healthy adults

Background

Physical activity and exercise is central to conservative management of knee osteoarthritis (KOA), but is often difficult for patients with KOA to maintain over the decade or more prior to surgical management. Better approaches are needed for maintaining physical function and health in this population that can also address the patho-biomechanics of the osteoarthritic knee.The objective of the study is to quantify how a lower-extremity robotic exoskeleton (dermoskeleton) modifies the external knee moments during over-ground walking in a sample of healthy adults, and to evaluate these biomechanical modifications in the context of the osteoarthritic knee.

某校高中生1997与2011年配戴眼镜情况调查

目的观察中学生配戴眼镜的情况变化,为指导学生正确配戴眼镜提供依据。方法 1997与2011年采用同量表,在同所学校,抽取高三年级1～4班的已配戴眼镜的全部学生。结果学生戴镜率有所提高,1997年为52.2%,2011年为59.6%。戴镜前试行近视眼治疗的情况有所好转,1997年为6.2%,2011年上升到11.5%。配镜前在医院散瞳验光的明显减少,1997年为22.6%,2011年下降到14.5%。1997年低度近视者中,有71.7%的学生眼镜时戴时脱,2011年为65.4%。1997年中高度近视者中,经常戴镜不随意脱掉的占60.0%,2011年为64.7%。结论学生缺乏配戴眼镜的基本常识,往往作出一些错误的选择。有关部门应积极采取措施,正确指导学生配戴眼镜,保护学生视力,防止近视加深。     

Medcall镜架与常规镜架配戴前后变形移位度量化分析

目的比较Medcall镜架与常规镜架配戴前后的变形移位程度,探讨眼镜配戴变形移位定量测定的可行性。方法选取2013年3-8月复旦大学附属金山医院眼科门诊验光配戴框架眼镜的6-17岁儿童及青少年共95例（Medcall镜架35例、常规镜架60例）,借助自制的镜架配戴变形移位测定器,对所有镜架予数码照相记录,数据导入Auto-CAD软件,量化分析镜架外张角（双侧镜腿夹角之和）及镜腿间距离。1个月后对随访到的29例儿童及青少年（Medcall镜架14例、常规镜架15例）再次进行上述测量,比较儿童配戴不同类型眼镜前后眼镜的变形移位度。结果配戴前14例Medcall眼镜及15例常规镜架的平均镜架外张角分别为（＋3.89±4.58）°及（＋0.97±5.76）°,2组间差异无统计学意义（t=1.50,P=0.14）。平均镜腿距离分别为（135.1±6.7）mm及（130.4±13.9）mm,差异无统计学意义（t=1.14,P=0.27）。配镜1个月后,2组镜架外张角分别为（＋4.69±4.57）°及（＋8.49±5.14）°,2组间差异有统计学意义（t=2.09,P=0.04）。镜腿间距离分别为（136.1±6.7）mm及（145.3±7.4）mm,差异有统计学意义（t=3.51,P〈0.05）。14例Medcall镜架初配及配戴1个月后,两者间镜架外张角及镜腿间距离差异均有统计学意义（配对t=4.49,P〈0.05;t=2.79,P〈0.05）;15例常规眼镜初配及配戴1个月后,两者间镜架外张角及镜腿间距离差异均有统计意义（t=9.83,P〈0.05;t=5.41,P〈0.05）。结论眼镜架随配戴时间延长会出现变形移位,Medcall镜架与常规镜架相比配戴后变形移位更小,本测量方法可以客观观察到眼镜的变形移位情况。     

输精管结扎改良术的临床研究

目的:评价输精管结扎改良术的临床效果,探求一种输精管结扎术后并发症或难治愈性并发症发生率更低的男性绝育手术方式。方法:选取自愿要求双侧输精管结扎,且无手术禁忌证的健康男性1196例,随机分成两组:一组采用传统手术入路的直视钳穿法输精管结扎术,另一组采用改良手术入路的直视钳穿法输精管结扎术。两组术后随访1-5年,观察手术效果。结果:与传统手术方法相比,改良手术附睾郁积症等难治愈性术后并发症发生率更低。结论:改良手术入路的直视钳穿法输精管结扎术是一种值得推广的男性绝育手术方式。