Drug Therapy of Essential Hypertension

Satisfactory control of blood pressure with a minimum of drugs and of side effects is the goal of drug therapy of essential hypertension. All patients do not respond alike to the antihypertensive drugs. Generally a thiazide diuretic is given first. If another drug is needed, dosage can be smaller and side effects minimized. Many patients require more than one drug to control their hypertension. The rationale and action of other appropriate drugs are also discussed.     

A Pilot Study Comparing of Two Therapy Regimens Following Carpometacarpal Joint Arthroplasty

ABSTRACT

Purpose. The purpose of this pilot study was to compare two occupational therapy regimens following arthroplasty: thumb splint plus home program and thumb splint plus occupational therapy. Methods. Nine participants who underwent a ligament reconstruction and tendon interposition surgery of the carpometacarpal (CMC) joint of the thumb were randomly assigned to either receive a splint and occupational therapy intervention or receive a splint and a home exercise program. Participants were assessed preoperatively and 6 months postoperatively using standardized assessments of joint motion, hand function, strength, and self-reports of pain and functional ability. Results. In each group, participants improved on all measures after surgery but there were no significant differences between the groups. Conclusion. The results suggest that either occupational therapy regimen postsurgery is effective but because of the small sample size, the results should be interpreted with caution.     

关于医务人员CPR质量的初步研究

目的:了解急救科室(急诊科和ICU)与普通科室(除急诊科、IVU、CCU、麻醉科外的临床科室)的医务人员心肺复苏(CPR)知识、技能掌握情况,研究两组有无差别及应用反馈装置能否提高胸外按压质量.方法:从急救科室与普通科室医生、护士群体中各随机抽取20名(共80名),对其进行CPR知识计分并记录应用反馈装置前后两轮均历时3 min的胸外按压参数,统计并比较上述4个群体CPR知识、质量情况及应用反馈装置前后CPR质量变化情况.结果:急救科室的医生、护士的CPR知识得分、有效按压率明显高于普通科室,应用反馈装置后普通科室的医生、护士CPR有效按压率明显提高.结论:普通科室医务人员CPR知识和技能掌握情况欠理想,急救科室的情况要好些.胸外按压操作时应用一种反馈提示装置可提高医务人员尤其是普通科室医务人员的的CPR质量.     

联合采用降压药物治疗原发性高血压病的临床意义

目的:探讨单剂与联合应用降压药物对高血压患者血压的影响及临床意义。方法:选取正在口服抗高血压药物至少1 个月以上的高血压病患者380例,按服用单剂(EH1组,212例)和联合用药(EH2组,168例)进行分组,对比分析血压控制情况及降压有效率。单独分析31例高血压合并糖尿病患者的血压控制情况。结果:EH2组的降压有效率(83.9%)明显高于EH1组(56.6%,P<0.005);EH2组的平均收缩压与舒张压均低于EH1组(P<0.001);服用单剂降压药物无效而改为增加药物剂量的患者,其血压降低均值明显小于改为联合用药的患者(P<0.01);31例高血压病合并糖尿病的患者降压有效率仅为35.5%,并且多为联合用药的患者。结论:小剂量联合应用抗高血压药物的降压效果明显优于单剂药物,单剂药物效果不明显而改为联合用药的降压效果明显优于单剂药物增加剂量的效果。     

Rotavirus Infection in India: A Major Cause of Childhood Gastroenteritis

Rotaviruses are genetically highly variable, non-enveloped viruses with a double-stranded, segmented ribonucleic acid genome. It is the single most important cause of severe, dehydrating gastroenteritis in infants and young children worldwide. Rotavirus gastroenteritis is associated with high morbidity in developed countries and significant mortality in developing countries. In children aged less than 5?years, they are the most frequent agent of severe acute diarrheal illnesses. Typically, symptomatic rotavirus diseases in infants (<5?years) and the elderly (>70?years) arise with sudden onset of watery diarrhoea with high risk of dehydration, accompanied by vomiting. Fecal-oral transmission is the most likely route of virus spread. Group A serotype strains G1 through G4 account for more than 90% of rotavirus gastroenteritis in humans, with G1 being the predominant serotype. The virus preferentially infects the mature small-intestinal enterocytes. Treatment of rotavirus diarrhoea is usually symptomatic and comprises a sufficient fluid and electrolyte substitution. Although nitazoxanide and some other drugs show high efficacy against rotavirus in vitro and in vivo, there is currently no recommended specific antiviral therapy. In India, two efficient and secure live vaccines against rotaviruses have been approved. Rotarix (GSK) vaccine is derived from single attenuated human rotavirus G1P[8], whereas RotaTeq (Merck) is a pentavalent mixture of naturally attenuated bovine/human rotavirus reassortants. Though these vaccines have already dramatically decreased the morbidity associated with rotavirus in countries where they are widely used, the third generation of vaccines, based on inactivated viruses or recombinant virus like particles are already in pipeline. For prophylaxis, special attention should be paid to adequate hygienic rules. Because of the high stability of rotaviruses to changing environmental conditions, disinfection should be performed applying disinfectants with proven activity against rotaviruses.     

Comparative Study on Tree Diversity and Population Structure in Two Forest Types of Nagaland,India

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - A study was carried out to investigate the population structure and tree species diversity in two different...     

Nurses'' Tobacco-Related Knowledge, Attitudes, and Practice in Four Major Cities in China

PURPOSE: To (a) identify Chinese nurses' tobacco-related knowledge, attitude, and practice (KAP), including perception of competency in smoking-cessation interventions; (b) identify barriers and facilitators to smoking cessation interventions to patients; and (c) assess the learning needs and smoking status of nurses. Design: A cross-sectional survey was conducted in four major cities (Beijing, Shanghai, Guangzhou, and Chongqing) in China from November to December 2003. METHODS: 2,888 registered nurses working in hospitals affiliated with five university schools of nursing in these cities were invited to complete a questionnaire. An instrument used to assess tobacco-related KAP in Hong Kong was translated into Chinese and pilot tested to ensure reliability and validity. FINDINGS: 2,179 questionnaires were returned and after exclusion of the grossly incomplete questionnaires, 1,690 were included in the present analysis. Only 2% of participants were current and 1% were former smokers; most had not received training for smoking-cessation interventions as part of their nursing education program. Two-thirds recognized smoking as a leading cause of preventable death and that smoking cessation was the most cost effective intervention, but only a third routinely assisted patients' quit attempts. Nurses who received training reported greater competence in providing smoking-cessation intervention, and more frequent practice of cessation interventions. CONCLUSIONS: Chinese nurses had some knowledge about the health effects of tobacco use, but seldom practiced smoking-cessation interventions. Those who had prior training had greater competence and more practice. Including tobacco control, especially smoking cessation, in nursing curricula in China has the potential to save millions of lives.