艾灸在初产妇产后初期乳胀护理中的应用

[目的]探讨护理产后乳房肿胀的有效方法。[方法]将产后乳胀的初产妇50例随机分为实验组与对照组。实验组26例采用艾灸疏通乳腺管处理;对照组24例采用传统热敷按摩方法,观察两组乳房胀痛消失时间及24h乳汁排出量情况。[结果]实验组减轻乳房胀痛的效果明显优于对照组(P<0.01);实验组24h乳汁排出量明显多于对照组(P<0.01)。[结论]艾灸护理产后乳房胀痛效果明显优于热敷按摩疏通乳腺管传统方法。     

急性心肌梗死早期生化标志物在AMI早期诊断中的应用

目的研究急性心肌梗死（AMI）早期生化标志物心型脂肪酸结合蛋白（H—FABP）、肌红蛋白（Mb）、C反应蛋白（CRP）在AMI早期诊断中的应用价值，并与肌钙蛋白I（cTnI）比较，为AMI的早期诊断提供更理想的指标。方法观察AMI患者36例，在不同的时间段测定H—FABP、Mb、CRP、cTnI并与40例健康人检测结果进行比较。结果CRP在AMI发生4h后升高，在24h内均有较高水平，敏感性也较高。H—FABP与Mb在AMI发生后1h即开始升高，较CRP提前释放，持续至12h，且敏感性较高。H—FABP特异性高于Mb及CRP。cTnI在AMI发生1h后有阳性枪出，但只有在6h后有较高的检出率，且持续时间较长。结论H—FABP较CRP、Mb、cTnI对早期AMl（特别是6h内）更具诊断价值，cTnI为AMI的确定标志物，早期生化标志物H—FABP与cTnI一起可望成为AMI诊断的重要检测标志物。     

Recognize cholesteatomas early

Cholesteatomas are benign tumors that develop in the middle ear, and their rapid growth patterns can impinge on local structures, resulting in adverse sequelae such as hearing loss, pain, or neuropathies. These late signs and symptoms can be avoided by early identification and prompt intervention. Primary care providers should be aware of the incidence, prevalence, identification, and associated symptoms of cholesteatomas to reduce the later untoward affects and promote prompt referral.     

Outcome of early school-age migraine

We studied the outcome of migraine from early school-age to prepuberty in a group of 84 children. The children belonged to a population-based, unselected follow-up sample of a 1-year age cohort. At the age of 8 to 9 years, 95 (2.7%) children of this age cohort had migraine according to a postal questionnaire. At age 11 to 12 years, 84 of them were traced and interviewed face-to-face. Only four (4.8%) of these children no longer had headache. Fifty-three (63.1%) children had migraine. Seventeen (20.2%) had migraine-type headache which did not completely fulfil the International Headache Society criteria for migraine, seven (8.3%) children had episodic tension-type headache and three (3.6%) had other headache. Among the children who had migraine at age 11 to 12, boys had significantly more frequent migraine attacks than girls (mean 2.7/month versus 1.8/month; p =0.016). They also used more drugs and were more frequently absent from school because of headache than girls, but these differences were not significant. Problems in the relationships between parents seemed to be another factor associated with frequent migraine.     

Parents' experiences of early support

In Finland, support for families with children is given, as far as possible, as part of basic services. However, to support basic services, services of this kind have also been generated as the result of several projects. The public sector itself has been reorganized and reformed to more resemble a project. In this article, the experiences of parents with children receiving project‐based support are studied qualitatively. Preventive support was offered via child health and maternity clinics in the form of home visiting. The reform of the municipal and service structure has made the development of preventive services an issue of even greater current relevance. The purpose of the study was to collect and explore the experiences of parents as reported in their own voices. The research question is, how did families experience this novel support model in practice? The data consist of interviews with six client families, including mothers and fathers, nine parents in all. A qualitative and narrative approach to the interview data was used. Analysis of the interviews yielded the following themes: being critical about the support given, building trust between parents and the professionals and empowering parents through support. According to the results, parents experienced receiving early support, and especially home visiting, as useful. The purpose of home visiting was not always clear to begin with, and consequently, some parents had reservations about them. Experiences of maternity and child health clinics varied. In addition to the health professionals' skills, their personality, familiarity and supportive and trustful way of working was felt to be most important. Parents felt that their parenting skills and relationships met with approval during the family work. Further research is needed on this kind of early support, especially support delivered at home, to develop these services.     

The importance of early intervention

This study involved a qualitative analysis of speech errors in children with autism spectrum disorders (ASDs). Participants were 69 children aged 5–13 years; 30 had high functioning autism and 39 had Asperger syndrome. On a standardized test of articulation, the minority (12%) of participants presented with standard scores below the normal range, indicating a speech delay/disorder. Although all the other children had standard scores within the normal range, a sizeable proportion (33% of those with normal standard scores) presented with a small number of errors. Overall 41% of the group produced at least some speech errors. The speech of children with ASD was characterized by mainly developmental phonological processes (gliding, cluster reduction and final consonant deletion most frequently), but non-developmental error types (such as phoneme specific nasal emission and initial consonant deletion) were found both in children identified as performing below the normal range in the standardized speech test and in those who performed within the normal range. Non-developmental distortions occurred relatively frequently in the children with ASD and previous studies of adolescents and adults with ASDs shows similar errors, suggesting that they do not resolve over time. Whether or not speech disorders are related specifically to ASD, their presence adds an additional communication and social barrier and should be diagnosed and treated as early as possible in individual children.     

Clinical management of early syphilis

Early syphilis therapy was a focus of intense research in the early 20th century with many and varied approaches being used. The development of penicillin and its efficacy in the treatment of syphilis transformed syphilis management for many with and at risk for infection. However, problems such as beta-lactam allergies and the desire for easily administered, alternate therapies have led to evaluation of multiple other drugs, with doxycycline currently recommended as the main alternative. Ceftriaxone and azithromycin have been shown to be effective, however, each has its own difficulties. Follow-up relies on serological testing, leading to concerns when these tests do not decline appropriately. Given concerns about the potential for increased risk for treatment failure, patients with HIV and pregnant women are of particular concern.     

Management of early Parkinson's disease

The two major questions in the treatment of early PD are (1) Does selegiline slow neuronal loss and delay the progression of clinical disability? and (2) Should dopamine agonists be used as initial symptomatic therapy in early disease rather than levodopa/PDI to reduce long-term disability and delay the onset of motor fluctuations and dyskinesia? Selegiline affords neuroprotection for dopamine neurons in cell culture systems and the results of several clinical trials are consistent with the hypothesis that it is neuroprotective in Parkinson's disease. Several clinical trials have found that initial symptomatic therapy with dopamine agonist to which levodopa/carbidopa is later added when needed leads to a lower incidence of long-term motor complications. These strategies are now being tested in prospective, randomized, blinded trials, many of which include PET or SPECT scans to assess the rate of dopamine neuron loss. These trials will provide more definitive answers to guide the early medial management of Parkinson's disease in the future.