What is the impact,prevalence, disability,and quality of life of pediatric headache?

Pediatric headache is a common health problem in children, with a significant headache reported in more than 75% by the age of 15 years. Pediatric migraine occurs in up to 10.6% of children between the ages of 5 and 15 years and in up to 28% of adolescents between the ages of 15 and 19 years. Given this high frequency, the impact of this disease on the lives of these children and their parents can be quite significant. This impact can be assessed with disease-specific disability and impairment as well as disease non-specific effects on quality of life. The goal of evaluation should be recognition of this impact, whereas the goal of management should be effective treatment that minimizes the impact of this disorder in the short term and for the life of the patient.     

Hospices in partnership? Public health,end of life,and the responsibility of hospices

Public health approaches to palliative care must appreciate that health professionals are part of communities, and the importance of partnerships should not be ignored – despite the inherent challenges. The true partners in a public health approach towards the end of life are of course, dying people, their families and friends, and members of the communities within which they are living and dying. However, we ignore important partnerships with nurses, doctors, and other healthcare professionals at our peril. This paper situates hospices within the broader community and uses vignette's to highlight approaches to community engagement and the challenges of partnership.     

Impact of intervened hypertension,hyperlipemia,hyperviscosity syndrome in incidence of cardiovascular and cerebrovascular diseases

Background：AccordingtoAmericanHeartAssociation＇sre－port，deathcompositionofcerebrovascularandcerebrovasculardis－easewasincreasedto２９％in１９９６，andnow３３％from２５％in１９９２．Now，atherosclerosisseriouslyendangerhuman＇shealth．Hypertension，hyperlipemiaandhyperviscositysyndromearemainriskfactorsofcardiovascularandcerebrovasculardis－eases．Thereconditionsoftenexistedsimultaneouslyinel－ders．Interventiontothesediseasescanpreventcardiovascularandcerebrovascularevents，whichisfeasi…     

Mechanisms of resistance and clinical relevance of resistance to β-lactams, glycopeptides, and fluoroquinolones

The widespread use of antibiotics has resulted in a growing problem of antimicrobial resistance in the community and hospital settings. Antimicrobial classes for which resistance has become a major problem include the β-lactams, the glycopeptides, and the fluoroquinolones. In gram-positive bacteria, β-lactam resistance most commonly results from expression of intrinsic low-affinity penicillin-binding proteins. In gram-negative bacteria, expression of acquired β-lactamases presents a particular challenge owing to some natural spectra that include virtually all β-lactam classes. Glycopeptide resistance has been largely restricted to nosocomial Enterococcus faecium strains, the spread of which is promoted by ineffective infection control mechanisms for fecal organisms and the widespread use of colonization-promoting antimicrobials (especially cephalosporins and antianaerobic antibiotics). Fluoroquinolone resistance in community-associated strains of Escherichia coli, many of which also express β-lactamases that confer cephalosporin resistance, is increasingly prevalent. Economic and regulatory forces have served to discourage large pharmaceutical companies from developing new antibiotics, suggesting that the antibiotics currently on the market may be all that will be available for the coming decade. As such, it is critical that we devise, test, and implement antimicrobial stewardship strategies that are effective at constraining and, ideally, reducing resistance in human pathogenic bacteria.     

Effect of l-NAME, an inhibitor of nitric oxide synthesis, on plasma levels of IL-6, IL-8, TNFα and nitrite/nitrate in human septic shock

Objectives: We tested the effects of N^G-nitro-L-arginine methyl ester (l-NAME), an inhibitor of nitric oxide (NO) synthesis, on plasma levels of interleukin (IL) IL-6, IL-8, tumor necrosis factor-alpha (TNFα) and nitrite/nitrate (NO ₂ ^? /NO ₃ ^? ) in patients with severe septic shock. Design: Prospective clinical study. Setting: Surgical intensive care unit at a university hospital. Patients: 11 consecutive patients with severe septic shock. Interventions: Standard hemodynamic measurements were made and blood samples taken at intervals before, during, and after a 12-h infusion of l-NAME 1 mg · kg^?1 ·h^?1 for determination of plasma IL-6, IL-8, TNFα and NO ₂ ^? /NO ₃ ^? concentration. Measurements and results: Patients with sepsis had increased plasma levels of IL-6, IL-8, TNFα, and NO ₂ ^? /NO ₃ ^? (p<0.05). Plasma levels of IL-6, IL-8, and NO ₂ ^? /NO ₃ ^? were negatively correlated with systemic vascular resistance (r=?0.62, r=?0.65, and r=?0.78, respectively, all p<0.05). Continuous infusion of l-NAME increased mean arterial pressure and systemic vascular resistance, with a concomitant reduction in cardiac output (all p<0.01). No significant changes were seen in levels of plasma IL-6, IL-8, and NO ₂ ^? /NO ₃ ^? during the 24-h observation period. Plasma levels of TNFα were significantly reduced during l-NAME infusion compared to baseline (p<0.05). Conclusions: NO plays a role in the cardiovascular derangements of human septic shock. Inhibition of NO synthesis with l-NAME does not promote excessive cytokine release in patients with severe sepsis.     

The use of opioids in the treatment of osteoarthritis: When,why, and how?

As life expectancy increases every decade, the incidence and prevalence of osteoarthritis (OA) also will increase. Despite progress in our knowledge of the pathophysiology of OA, the management of OA-mediated pain continues to challenge physicians. Concern regarding the cardiovascular effects of cyclooxygenase-2 inhibitors and the gastrointestinal and renal side effects of nonsteroidal anti-inflammatory drugs (NSAIDs) in general has limited the use of these medications in the management of chronic non-cancer pain. Appropriately dosed and monitored use of opioids for OA pain, when more conservative methods have failed, has potentially fewer life-threatening complications associated with it than the more commonly and often less successfully employed pharmacotherapeutic approaches to care. When used as part of a multimodal approach to pain control, opioids are a safe and effective treatment for joint pain, including that of OA. Patients for whom NSAIDs are contraindicated, or for whom combined acetaminophen, tramadol, and NSAID therapy is ineffective, may be started on low-dose opioids and titrated as needed and tolerated. Patient education and informed consent, exercise, complementary medicine, and the use of a controlled substance agreement increases the likelihood of patient compliance with treatment guidelines, improving functional capacity and quality of life.     

Abstracts of the 2012 International Congress of the European Association of Poisons Centres and Clinical Toxicologists, 25 May–1 June 2012, London,UK

Abstract

Groups of ewes were gavaged Veratrum californicum root-rhizome material over various 3 day periods during early gestation and their late-term fetuses examined. Resulting from gavage near day 29 were shortening of fetal metacarpal, metatarsal and tibial bones. Fibulae bowed severely when tibiae were shortened. Medial bowing of forelimbs at the fetlocks resulted from unequal shortening of fused metacarpi. Severe joint articular surface defects and arthrogryposis were present in some of the lambs from treatment ewes. There was bilateral and twinning symmetry in limb bone shortening. Severity of limb defects varied with gestational stage at time of gavage.     

nese Academy of Sciences, Dalian 1

medicine, foodstuff and otherwise has great profound significance in practice.silk fibroin; silk; amino acid0精细与专用化学品Fine and Specialty Chemicals16-21TQ936B018;73;BB018_73;王佳培0006001000260003     

ool of Basic Medical Sciences,Centra

Central South University,Changsha 410011,China)A new type of magnetic bioactive ceramics(MBC)was prepared by sintering precursor powders derived from sol-gel process.The microstructure,crystal phases and bioactivity of the samples were investigated via in vitro method and XRD,SEM and IR techniques.Results show that superfine precursor powders with noncrystalline structure can be prepared from sol-gel process.The main crystalline phases of the sintered cer