Expanding Nursing''s Practice Terrain: Imperatives for Future Viability

Changes in perceptions of health needs, which are increasingly sociocultural in nature, and changes in health services shifting from medical control to entrepreneurial opportunities and corporate business control will necessarily have an impact on nursing. Nurses can capitalize on this, expanding their practice dimensions within the boundaries of current employment as well as joining in competitive health marketplace ventures. This will ensure relevance and continued viability of the profession in a dynamic, open, health services field.     

医学人文的过去，现在和未来

医学人文经历了蓬勃发展的100年,其内涵不断丰富,研究方向不断拓展,为医学教育提供了巨大帮助。本文从医学人文的定义出发,梳理医学人文近100年来的学科发展史,重点回顾医学史、生命伦理学、医学人类学和叙事医学的发展历程,并通过分析医学人文运动背后的原因,阐述中国医学人文未来发展要求,以期促进我国医学人文领域开展更深入的研究与教育。     

医学人文的过去，现在和未来

医学人文经历了蓬勃发展的100年,其内涵不断丰富,研究方向不断拓展,为医学教育提供了巨大帮助。本文从医学人文的定义出发,梳理医学人文近100年来的学科发展史,重点回顾医学史、生命伦理学、医学人类学和叙事医学的发展历程,并通过分析医学人文运动背后的原因,阐述中国医学人文未来发展要求,以期促进我国医学人文领域开展更深入的研究与教育。     

Central Acting Antihypertensive Drugs: Past, Present, and Future

The central antihypertensive drugs such as methyldopa or clonidine have been agents of importance in the therapy of hypertension. Due to the side effects and the rebound hypertensive phenomenon in the case of clonidine, the use of these agents have been clearly diminished. There are several evidences that a new type of receptor, imidazoline receptor, is present in the central nervous system and in the periphery. A specific agonist for these receptors, rilmenidine, has been studied in experimental animals and in hypertensive patients. Clinical studies have shown that rilmenidine exhibits similar efficacy but a better tolerability compared to clonidine. Rilmenidine may represent a good alternative in the therapy of hypertension.     

The Monocyte Monolayer Assay: Past,Present and Future

Serologic testing using the indirect antiglobulin test (IAT) is known to be insufficient to determine the clinical significance or insignificance of a given antibody to red blood cells (RBC), particularly in cases of antibodies to high-prevalence antigens, such as anti-Ge or anti-Yt^a. An in vitro functional cellular assay, the monocyte monolayer assay (MMA), has been studied for more than 40 years for its potential use to differentiate between clinically significant and insignificant RBC antibodies. The MMA has recently been used to select donor blood for transfusion into patients having a serologically incompatible crossmatch, without any obvious sequalae. Thus, the MMA shows great potential for future use to select donor blood for transfusion in situations where antibodies to high-prevalence antigens or complex multiple alloantibody problems confront transfusion services. In this report, we review the history leading up to the current uses of the MMA, its optimization, and potential use for the selection of serologically incompatible donor blood for transfusion. We describe current ongoing work to document and improve the efficacy of the MMA. Finally, we briefly describe possible future directions to make the MMA more amenable to routine laboratories.     

Past and Future: Responsibility and Opportunity

Abstract

Identification and management of chronic lumbar spine instability is a clinical challenge for manual physical therapists. Chronic lumbar instability is presented as a term that can encompass two types of lumbar instability: mechanical (radiographic) and functional (clinical) instability (FLI). The components of mechanical and FLI are presented relative to the development of a physical therapy diagnosis and management. The purpose of this paper is to review the historical framework of chronic lumbar spine instability from a physical therapy perspective and to summarize current research relative to clinical diagnosis in physical therapy.     

Helicobacter pylori: The Past,Present, and Future in Management

Helicobacter pylori is a common bacterial pathogen responsible for substantial gastrointestinal morbidity worldwide. Helicobacter pylori infection can be clinically challenging, given the numerous diagnostic and therapeutic options available. In this article, we provide a systematic review of H pylori epidemiology and pathogenesis. In addition, we provide a simplified approach to the diagnosis and treatment of H pylori infection, suitable for application in the primary care setting. On completion of this article, one should be able to (1) state the indications for H pylori testing; (2) identify noninvasive and invasive tests to diagnose H pylori infection; and (3) describe the advantages and disadvantages of various treatment regimens.     

循证医学:过去、现在和未来(二)

3什么是循证医学的证据 医疗实践的目的是为了让病人健康、长寿.而判定循证实践效果则应设计试验,将医学生随机分配到接受传统和循证医学训练的两个组,追踪随访他们毕业后若干年治疗病人的效果.但很多因素限制了这种试验的实施.