Evaluation and Treatment of Patients with Dementia

Dementia is a common problem in middle-aged and elderly adults. Thorough diagnostic evaluation uncovers a significant minority who are suffering from an underlying neuropsychiatric disease amenable to specific medical or surgical therapy. Even in those patients with brain atrophy of unknown cause the physician can offer counseling and environmental manipulation to maximize remaining intellectual capacity.     

老年神经性阳痿电磁刺激振动按摩治疗及机理探讨

为探讨老年神经性阳痿的有效治疗方法及机理 ,在临床实验的基础上 ,用电磁刺激阴部神经和阴茎振动按摩治疗老年神经性阳萎 6 0例 ,用神经电生理、脉冲多普勒超声和微机图像扫描技术探讨了其治疗机理。 6 0例神经性阳痿病人中 ,临床治愈 37例 (6 1 7% ) ,显效 9例 (15 % ) ,好转 5例 (8 3% ) ,总有效率为85 %。与治疗前相比 ,阴部神经兴奋传导时间速度、阴茎勃起动脉横截面积及血流量均有显著性差异 (P 相似文献   

阳萎患者心理状况初步调查

目的 :探讨功能性阳萎患者的个性特征、情绪、生活质量等心理社会影响因素 ,为阳萎的预防和治疗提供线索。方法 :用艾森克个性问卷、Beck抑郁自评量表、世界卫生组织编制的生活质量量表 (theWorldHealthOrganizationQualityoflife ,WHOQOL)对 89例阳萎患者和 76例健康自愿者进行评定。结果 :①抑郁评定 :阳萎患者组抑郁量表总分 14 35± 5 5 7,达到了中度抑郁的分数线 ,且显著高于正常组 (P <0 0 5 ) ;②艾森克个性问卷 :阳萎患者组E分明显低于正常组 (p <0 0 5 ) ,N分明显高于正常组 (p <0 0 5 ) ,L、P分两组之间无明显差异 ;③生活质量评定 :精神健康、自我评估、夫妻关系、家务和生活自理、人际关系、躯体健康、社会支持因子分明显差于正常组 (P <0 0 5 ) ;工作能力、认知功能、休闲活动、经济状况、居住、宗教信仰等生活质量维度的评估与正常人相比无明显差异 (p >0 0 5 )。④在阳萎患者人群中 ,情绪稳定性和内外向维度与夫妻关系、社会支持的评估、抑郁情绪、人际关系、家务和生活自理能力呈显著相关。结论 :阳萎患者的抑郁情绪、夫妻关系、社会支持、人际关系等方面的生活质量较差 ;内向不稳定的性格较多见     

Home-Based Treatment with Immunoglobulins: an Evaluation from the Perspective of Patients and Healthcare Professionals

Purpose

This study aims to evaluate home-based treatment with immunoglobulin (IgG) by assessing and comparing the experiences and perceived value of patients and healthcare professionals, and potential differences in experiences between subcutaneous (SCIg) and intravenous (IVIg) modes of administration. As choices on the location and type of treatment are determined in a shared decision-making process, we evaluated the home-based treatment from the perspectives of both patients and professionals.

Methods

A questionnaire study was conducted among 205 patients, 44 informal caregivers, 43 hospital professionals, and 21 nurses of the Sanquin Home Service (SHS) that provides home treatment with immunoglobulins in the Netherlands. Experiences, perceived benefits, and effects on the patients’ quality of life and overall ratings were assessed.

Results

Both patients and professionals were predominantly positive about the home treatment, irrespective of the administration mode. The home-based treatment with Ig contributed to the patients’ autonomy, participation, and perceived health. Patients and informal caregivers valued the treatment with a global rating of 8.84, and professionals with 8.32 (on a scale from 0 “worst” to 10 “best possible care”). SCIg and IVIg patient groups differed in their experiences regarding the accessibility and communication of the home treatment service. Furthermore, hospital professionals reported lower effects on quality of life than patients themselves.

Conclusions

Home-based treatment with immunoglobulins is highly valued because of its personalized and effective character, meeting the needs and preferences of patients. Nonetheless, patients and professionals do have different perspectives on the value of this type of care.

     

Evaluation of the Efficiency and Safety of Combined Treatment with Impaza and Nitrates in CHD Patients with Erectile Dysfunction

The safety of combined administration of ultralow doses of antigens to endothelial NO synthase (impaza) and nitrates for the treatment of erectile dysfunction in CHD patients was evaluated in an open non-comparative clinical trial. The efficiency and safety of impaza and the possibility of its administration to patients receiving nitrates were demonstrated.     

Treatment of Patients with Vertigo and Balance Disorders

A new computerized method was developed for correcting and eliminating adverse illusory (vertigo), vestibulo-opto-oculomotor (nystagmus), and vestibulo-postural (balance) reactions allowing subjects to be trained to block the generalization of an afferent signal to the effector mechanisms of the CNS by acquisition of a fixation reflex using biological feedback. Two versions of the model were used, with the aims of inducing anomalous reactions of a defined sensory modality (visual or vestibular). A total of 24 patients with peripheral and central vestibulopathies were divided into two groups, one of which was trained visually, while the other was trained using a vestibular approach. The method allows anomalous illusory and vestibulo-opto-oculomotor reactions to be produced in the subjects and for these to be inhibited by acquisition of a fixation reflex. The visual correction method was the most effective for patients with peripheral vestibulopathy, while the vestibular method was the most effective for those with central vestibulopathy.     

哌拉西林/他唑巴坦治疗老年呼吸道感染的 临床效果分析与评价

目的 探究分析老年呼吸道感染应用哌拉西林/他唑巴坦治疗的效果分析与评价。方法 选取2013年3月~2017年6月我院收治的老年呼吸道感染患者78例为研究对象,随机分为对照组和观察组,每组39例。对照组患者采用哌拉西林/舒巴坦治疗,观察组患者采用哌拉西林/他唑巴坦治疗。比较两组患者的临床治疗效果及生活质量评分。结果 观察组患者治疗总有效率为94.87%,高于对照组的84.62%,组间比较,差异具有统计学意义（P＜0.05）。观察组患者的健康感觉（106.92±4.26）分,睡眠状态（11.35±3.02）分,生活满足感（25.14±1.39）分,对照组患者的健康感觉（86.71±5.06）分,睡眠状态（5.34±2.26）分,生活满足感（15.83±3.16）分,组间比较,差异具有统计学意义（P＜0.05）。结论 老年呼吸道感染应用哌拉西林/他唑巴坦治疗的效果显著,在改善患者临床症状的同时,可有效提升患者的生存质量,效果显著,值得临床推广实践。     

Immunologic Evaluation of Patients with Cefotetan-Induced Anaphylaxis

Cefotetan is a commonly prescribed second-generation cephalosporin that acts against a wide range of bacteria. However, cefotetan-induced hypersensitivity has rarely been reported. We report 2 cases of cefotetan-induced anaphylaxis with immunologic evaluation. The first case was a 70-year-old asthmatic woman who had dyspnea and hypotension during administration of cefotetan, in which high serum-specific IgE to cefotetan-human serum albumin (HSA) conjugate was detected by enzyme-linked immunosorbent assay. The second case was a 63-year-old asthmatic woman who complained of chest tightness and dyspnea during cefotetan infusion, in which high serum-specific IgG1 and IgG4 with no serum specific IgE to cefotetan-HSA conjugate was detected. The basophil activation test using basophils from the patient showed a significant up-regulation of CD63 with the addition of anti-IgG4 antibody compared with that in non-atopic healthy controls. In conclusion, cefotetan can induce anaphylaxis, which may involve both IgE- and IgG4-mediated responses in the pathogenic mechanism.     

偏瘫患者肩关节半脱位的康复治疗及护理

目的 观察康复治疗及护理对偏瘫患者肩关节半脱位的影响.方法 对46例偏瘫合并肩关节半脱位患者进行正确康复治疗及护理.在治疗前后进行肩关节半脱位的测量和康复评定.结果 46例患者治疗后肩关节半脱位和上肢功能明显改善.结论 康复治疗及护理可有效预防和治疗肩关节半脱位.     

肿瘤患者伴发抑郁、焦虑症状的临床治疗

目的：验证帕罗西汀对肿瘤患者伴发的抑郁焦虑症状的治疗作用。方法：采用焦虑自评量表(SAS)、抑郁自评量表(SDS)选取伴焦虑、抑郁症状的肿瘤患者93例，随机分为二组。治疗组：每日口服帕罗西汀10-20mg，共4周，于治疗后进行SAS、SDS测评，并与对照组进行对照。结果：帕罗西汀治疗肿瘤患者伴发的抑郁焦虑症状有效率分别为：77．8％和71．1％，明显高于对照组。结论：帕罗西汀对肿瘤患者的抑郁、焦虑症状均有明显治疗作用。     

功能性消化不良患者伴抑郁障碍的诊断和治疗

目的：探讨功能性不良（FD）患者的抑郁障碍及抗抑郁药对其疗效。方法：以CCMD－2－R为标准诊断抑郁障碍。将伴抑郁的FD随机分为3组：文拉法新组，多塞平组和对照组（常规内科治疗）。以治疗前，治疗2周和8周FD症状积分及Zung抑郁自评量表（SDS）积分变化评定疗效。结果：（1）FD中抑郁障碍的发生率为32．28％。（2）FD症状积分在文拉法新组和多塞平组于治疗2周时即明显减少（P＜0．05），于治疗8周时非常明显低于对照组（P＜0．05）；SDS只分在文拉法新组于治疗2周时即明显减少（P＜0．05），文拉法新组和多塞平组于治疗8周时均明显低于对照组（P＜0．05）；（3）文拉法新组不良反应明显低于多塞平组。结论：FD伴发的抑郁障碍发生率高，抗抑郁治疗能有效改善消化不良和抑郁症状，文拉法新作用迅速且优于多塞平。     

Transfer Factor Treatment of Patients with Multiple Sclerosis

In five patients with definite multiple sclerosis and lack of cell-mediated immunity to measles and parainfluenza virus antigens, various immunological parameters were studied before and during transfer factor treatment. The study showed that cell-mediated immunity to measles virus antigen, as evaluated by the leukocyte migration agarose test, could temporarily be restored, using repeated injections of transfer factor pooled from unselected, normal blood donors.     

对于产科失血性休克危急重症患者的临床治疗分析

目的：探讨产科失血性休克危急重症的临床特点及处理措施。方法对从2011年4月~2014年9月入住我院接受治疗的98例血性休克患者给予积极的预防,严密的检测和有效的治疗。结果失血性休克患者经过有效抢救和积极治疗,抢救成功率达到100%。结论对产科失血性休克的临床特点展开分析,通过严密的监测机制和有效的抢救措施,对于挽救患者生命,提高患者术后生活质量是很有意义的。     

缺血性脑卒中康复治疗

目的 引导缺血性脑卒中患者接受正规治疗,减少缺血性脑卒中造成的损害,减少复发率,提高生活质量.方法 2008年09月121例作为管观察组,用药同时配合多种健康教育预防康复,2007年9月至2008年8月107例对照组,单纯药物治疗,评定缺血性脑卒中健康教育防治知识掌握及随诊情况.结果 观察组对缺血性脑卒中防治知识掌握良好,长期随诊率高于对照组.结论 对缺血性脑卒中采取防治健康教育可更好地引导患者配合系统地正规治疗,有利于患者的治疗及康复.     

无症状性脑梗死患者的心理功能测评

随着高敏度的脑成像技术如ＣＴ、ＭＲＩ在临床的广泛应用 ,发现了许多临床上无明显症状、体征或症状、体征与既往卒中史不相关的梗死灶 ,称之为无症状性脑梗死 (ａｓｙｍｐｔｏｍａｔｉｃｉｎｆａｒｃｔ)或静止性脑梗死(ｓｉｌｅｎｔｃｅｒｅｂｒａｌｉｎｆａｒｃｔｉｏｎ ,ＳＣＩ)。虽然这些病人经传统的神经系统检查未发现明显的异常 ,但有学者认为他们存在明显的认知功能障碍、精细运动障碍及情感障碍等。本文对 38例ＳＣＩ及 30例对照组进行了认知功能、记忆、精细运动、感知觉及情感等方面的评价 ,有利于ＳＣＩ以及血管性痴呆的早期防…     

抑郁症患者治疗前后归因方式的比较

目的 探索抑郁症患者治疗后归因方式的变化.方法 选取62名住院抑郁症患者,在接受常规药物治疗前后进行抑郁自评量表(SDS)、汉密尔顿抑郁量表(HAMD)和归因方式问卷(ASQ)的测评.同时选取58名无抑郁病史者作为对照组,测量抑郁自评量表(SDS)和归因方式问卷(ASQ).结果 ①抑郁症患者的抑郁水平与ASQ得分相关显著(SDS,r=-0.54,P＜0.01;HAMD,r=-0.38,P＜0.01);②抑郁症患者接受药物治疗后,抑郁状况显著改善(SDS,t=21.43,P＜0.01;HAMD,t=28.19,P＜0.01);③抑郁症组治疗后ASQ得分有所提高,但未达到显著水平(t=-1.62,P＞0.05).结论 抑郁症患者的负性归因方式在治疗后有所改善,但改善不明显,治疗后与对照组差异依然显著.归因方式并非抑郁症的伴随症状,而是抑郁者的一种相对稳定的且具有可变性的类特质.