Preventing encopresis

Pediatric nurses can play a major role in preventing encopresis through anticipatory guidance and education. An understanding of contributing factors that may lead to constipation and encopresis will assist pediatric nurses in their efforts to help prevent this condition.     

Short-term treatment with quazepam of insomnia in geriatric patients

In this randomized, double-blind clinical trial in 60 insomniac patients (including 41 aged 65 or older), 15 mg of quazepam was compared with placebo as a hypnotic. Patients received treatment for five consecutive nights after an initial three-night baseline period. Data on efficacy and safety were collected via postsleep questionnaires, physical and neurological examinations, electrocardiograms, electroencephalograms, and routine laboratory tests. According to patient's reports, the quantity and quality of sleep were significantly better (P less than 0.01) in the quazepam-treated group than in the group receiving the placebo. The physician also rated quazepam the better treatment. Eleven patients, six receiving quazepam and five receiving the placebo, had adverse experiences, including ataxia, which was observed in two quazepam-treated and one place-bo-treated patient. The resuls confirm that quazepam in a dosage of 15 mg/night is safe and that it is more effective than placebo in treating insomnia in older patients.     

Self-care interventions for the school-aged child with encopresis.

Encopresis, an elimination disorder in children, presents as a challenging problem for gastroenterology nurses working with patients and families confronted with this disorder. This article offers a summary of the literature on encopresis, including pathogenesis, causative factors, early treatment, and clinical interventions focused on self-care. The antecedent factors that facilitate the child's participation in self-care are summarized, along with the intended outcomes of the self-care intervention plan.     

Short-term treatment with prednisolone has no lasting effect on serum leptin

It has been suggested that the leptin-stimulating effect of short-term treatment with systemic glucocorticoids may last several weeks to months. The aim of the present study was to assess serum leptin during and four days after withdrawal of short-term treatment with prednisolone. The study comprised 20 healthy subjects (12 men and 8 premenopausal women aged 19-45 years: mean 31 years). The design was a randomized, double-blind, placebo-controlled, parallel group study with 2 days' run in, 3 days' treatment and 4 days' run out. No medication was given during run in and run out. During the treatment period the subjects took prednisolone, 20 mg twice daily, or placebo. Blood was collected on the last day of each period. In the prednisolone group comparisons of run in (mean serum leptin (+/- SEM) (4.94 (1.31)) with treatment (7.08 (1.39)) and run out (5.20 (1.84)) microg/L) showed a significant stimulating effect of treatment (p=0.03, t=-2.6, 95%, confidence interval -4.0 to -0.25 microg/L), whereas no statistically significant variation between run in and run out was detected (p=0.47, t=0.8, confidence interval -2.63 to 1.35 microg/L). Inter-group comparisons of run in with treatment and run out showed elevated leptin concentrations during prednisolone treatment (p=0.03) but no statistically significant variations between run in and run out data (p=0.88). In healthy adults the stimulating effects on serum leptin of short-term prednisolone seem to last only a few days after withdrawal of treatment.     

Short-term outcome of conservative treatment in athletes with symptomatic lumbar disc herniation

OBJECTIVE: The purpose of this study was to clarify the efficacy of conservative treatment in athletes with symptomatic lumbar disc herniation, especially in terms of their ability to return to their original sporting activities. DESIGN: A total of 71 consecutive athletes (53 men and 18 women), who consulted our sports medicine clinic during the 10-yr period between September 1993 and October 2003 because of severe low back pain or leg pain/numbness due to lumbar disc herniation (confirmed on magnetic resonance images), were studied. The mean age of the subjects was 21 yrs. All of them were conservatively treated by advising them to discontinue their sporting activities, with or without short-term medication. After the subjective symptoms had reduced by >80%, individual training was started to allow the athletes to return to their original sporting activities. RESULTS: A total of 56 athletes (78.9%) could return to their original sporting activities at an average of 4.7 mos (range, 1-12 mos) after the start of treatment and were able to sustain the activities for > or =6 mos, the minimum duration of follow-up in this study. The outcome of the conservative treatment was not influenced by the intensity of the sporting activity. Multiple logistic regression analyses showed that the only factor influencing the ability of the athletes to return to their original sporting activities was the severity of the symptoms before the start of treatment. CONCLUSION: The results of this study suggest that the short-term outcome of conservative treatment in athletes with symptomatic lumbar disc herniation may be satisfactory in terms of control of the symptoms and the ability of the athletes to return to their original sporting activities and that the subjective symptoms before treatment may be a key factor influencing the success of the conservative management. Randomized controlled trials, or even comparative follow-up studies, are needed to confirm our results.     

腹泻或大便失禁的危重患者肛周皮肤损伤的预防

目的：通过对腹泻或大便失禁的危重患者肛周皮肤的不同护理方法，观察其对肛周皮肤损伤的预防效果。方法：随机将97例腹泻或大便失禁的危重患者分为对照组（清水擦拭法）、实验组（婴儿用湿巾纸擦拭法、棉条塞肛法、或两种方法联用）进行肛周皮肤护理。结果：实验组和对照组对腹泻或大便失禁的危重患者肛周皮肤损伤的预防效果比较存在显著差异（P〈0.05），而两种方法联合应用组效果优于其他两组（P〈0.05）。结论：婴儿用湿巾纸擦拭法及棉条塞肛法能有效预防腹泻或大便失禁的危重患者肛周皮肤损伤。     

腺样体消融术同期咽鼓管球囊扩张术治疗儿童慢性分泌性中耳炎伴咽鼓管功能障碍的短期疗效

目的 观察腺样体消融术同期咽鼓管球囊扩张术治疗儿童慢性分泌性中耳炎伴咽鼓管功能障碍的短期疗效.方法 选择本院2019年1月至2020年5月收治的96例慢性分泌性中耳炎伴咽鼓管功能障碍患儿为研究对象,随机将其分为对照组与观察组,各48例.对照组采取腺样体消融术治疗,观察组采取腺样体消融术同期咽鼓管球囊扩张术治疗.观察并比...     

Reflexology in the management of encopresis and chronic constipation

Encopresis or faecal incontinence in children is an extremely distressing condition that is usually secondary to chronic constipation/stool withholding. Traditional management with enemas may add to the child's distress. This study investigated the efficacy of treating patients with encopresis and chronic constipation with reflexology. An observational study was carried out of 50 children between three and 14 years of age who had a diagnosis of encopresis/chronic constipation. The children received six sessions of 30-minutes of reflexology to their feet. With the help of their parents they completed questionnaires on bowel motions and soiling patterns before, during and after the treatment. A further questionnaire was completed by parents pre and post treatment on their attitude towards reflexology. Forty-eight of the children completed the sessions. The number of bowel motions increased and the incidence of soiling decreased. Parents were keen to try the reflexology and were satisfied with the effect of reflexology on their child's condition. It appears that reflexology has been an effective method of treating encopresis and constipation over a six-week period in this cohort of patients.     

Short-term treatment of vaginal candidiasis with fenticonazole ovules: a three-dose schedule comparative trial

In an unblinded, randomized parallel group trial three different therapeutic dose schedules of fenticonazole (vaginal ovules) were compared in the treatment of vaginal candidiasis. A total of 60 patients, aged 17-71 years, affected by mycologically confirmed symptomatic vaginal candidiasis were included and randomly allocated to three treatment groups: 200 mg daily, for 3 days; 600 mg in a single administration; and 1000 mg in a single administration. Therapeutic efficacy was assessed by microbiological and clinical criteria 7 days after the end of the treatment. All mycologically cured patients were re-checked, microbiologically and clinically, 2 weeks after the end of treatment to identify and evaluate possible relapses. The results obtained indicate that vaginal application of fenticonazole ovules is highly effective in producing both symptomatic relief and mycological sterilization of vaginal swabs in 75-85% of treated patients. No relapses were noted at the time of re-check. The three administration schedules tested appear to be equally effective and well tolerated. In one case only of the group given 200 mg and two cases of those given 1000 mg, a local burning sensation was noted. These results show that short-term treatment of vaginal candidiasis with fenticonazole ovules is effective and well tolerated.     

Short-term lamivudine for the treatment of chronic hepatitis B

Short-term lamivudine and its withdrawal were evaluated as regards an immunomodulatory therapy of chronic hepatitis B. Lamivudine was given for 3 or 6 months to 23 patients with chronic hepatitis B who were infected with hepatitis B virus (HBV) genotype C, including 15 with hepatitis B e antigen (HBeAg) and 8 without it. It decreased serum levels of alanine aminotransferase (ALT) and HBV DNA in HBeAg-positive patients. Flare-ups of ALT and HBV DNA after treatment were observed in most patients, and 4 of the 12 (33%) patients with 6-month lamivudine treatment remained in remission 6 months after withdrawal of the therapy. In HBeAg-negative patients, however, flare-ups of ALT and HBV DNA were mild. Normalization of ALT and a decrease in serum HBV DNA were accomplished in 6 of the 9 (75%) patients. Breakthroughs or serious side effects were not observed in any patients. Short-term lamivudine is safe and may offer a therapeutic option to patients with chronic hepatitis B.