Tea for Tooth

Agoodreasontochooseteaovercoffee :Drinkingteaonaregularbasismayhelpreduceyourteeth’ssensitivitytohotandcoldtemperatures .Thebenefitcomesfromtannicacid1,acompoundinblackteathatclogs2 microscopicholesinyourteeth .Fillingtheseholeshelpskeephotandcoldliquidsfromirritating3therootsofyourteeth ,saysNormanBitter,adentistinFresno ,California .Forpeoplewithsensitiveteeth ,acoupleofcupsofteaeachdaymaybeenoughtoeliminatetoothpain .　Vocabulary　　 1.tannicacid　n .[化 ]　鞣酸　　　　 2 .clog　 [kl g]v…     

Charcot—Mayie—Tooth氏病

Charcot—Marie—Tooth氏病(CMT)又称腓骨肌萎缩或神经性进行性肌萎缩症,因本病少见,易误诊。现结合我们收治的2例,分析如下: 例1:男,29岁,3年前无诱因出现双小腿无力,行走后易疲劳,小腿肌肉渐萎缩,1年前渐出现双足下垂,全身不定点肌肉痉挛,以腓肠肌好发。追问家族4代人,部分并进行了调查,无类似病人。查体:一般状况较好,双小腿肌萎缩明显,足尖下垂,不能背曲,马蹄足内翻,行走呈跨越步态,四肢末端呈手套、袜子型轻度感觉障碍,腹壁反射(-),双膝反射(+),双跟腱反射(-),病理反射(-)。腰穿结果正     

Can the use of LPNs alleviate the nursing shortage? Yes, the authors say, but the issues--involving recruitment, education, and scope of practice--are complex

OVERVIEW: LPNs may be able to help fill some of the gaps caused by the nursing shortage, but little research has been conducted on the demographic characteristics of LPNs, their education and scope of practice, and the demand for their services, all of which vary from state to state. In 2002 and 2003, the authors conducted a comprehensive national study, Supply, Demand, and Use of Licensed Practical Nurses, and have summarized that study's findings in this article. They found that RNs and LPNs are similar in age and tend to have similar numbers of children, but that racial and ethnic minorities, particularly African Americans, and those who are single, widowed, divorced, or separated are better represented among LPNs. Expanding LPN educational programs might draw more people into nursing. Some LPNs would like to become RNs, so expanding LPN-to-RN "ladder" programs could also be beneficial. LPNs can't replace RNs entirely, but they could perform much of the work now performed by RNs. While long-term care facilities already depend heavily on LPNs, hospitals could benefit from employing more LPNs. The authors make several specific policy recommendations to improve the education and employment of LPNs.     

Through which layer,between the gallbladder and the liver,does the deep branch of the cystic artery run?

Introduction: During laparoscopic cholecystectomy, an enlarged field of vision increases safety and precision, but surgeons often encounter bleeding that can cause difficulties. It is important to prevent and control arterial bleeding from Calot's triangle and the liver bed that results from injury to the deep branch of the cystic artery (DBCA). However, no previous reports have mentioned the layer between the gallbladder and liver through which the DBCA runs. Materials and Surgical Technique: To determine this layer, we investigated the histological findings from consecutive thin‐slice (3 mm) blocks in six cases (three cadavers and three patients who underwent extended cholecystectomy). Results: The subserosal layer of the gallbladder wall can be divided into an inner (ss‐i) layer, which consists of abundant vasculature and some fibrous tissue, and an outer (ss‐o) layer, which consists of abundant fat tissue. DBCA runs through the ss‐o layer, far from the ss‐i layer in Calot's triangle, and runs toward the gallbladder body and ramifies into several branches that flow into the ss‐i layer. Discussion: If the gallbladder is dissected in the layer close to the ss‐i layer, as in our standardized procedure, the subbranches of DBCA are transected at the border of the ss‐i layer, and most of the DBCA is left within the ss‐o layer in Calot's triangle and the liver bed. Knowledge of the anatomy of DBCA is useful to avoid and stop bleeding from the deep part of Calot's triangle and the liver bed.     

Mirror,mirror on the wall,who is the most improved of all?

This article examines the rhetoric and reality of clinical governance in the United Kingdom using the analogy of the New Year pantomime. The authors argue that processes to improve the quality of health care services provision have been in place for many years. Although the terms and language used to describe these processes have, over time, changed, the task remains the same. Clinical governance is the latest in a long list of such changes. The tensions involved in working towards achieving centrally driven targets and performance standards whilst at the same time addressing the huge modernization agenda are explored through managerial and clinical experiences. Whilst the clinical governance approach has undoubtedly achieved improvements, the sustainability of these is questioned. Organisational responses to the current system are explored and a glimpse into the future is given, as the present structures and processes change in 2004. The authors argue that practitioners and managers, who may have survived the current arrangements, might have considerably more difficulty in doing so in the future.     

Poison center surveillance data: the good,the bad and … the flu

Background.?Poison center data are increasingly used by state health departments and the Centers for Disease Control and Prevention for public health surveillance. Forrester and colleagues evaluated the ability of 6 Texas poison centers covering a population of 24 million to accurately code and report the number of H1N1 calls received over a 5-month period.?Discussion.?The Texas poison centers generated new coding and began work within 24 h of notification of the surveillance need. No additional staff were added for call management, coding, or quality assurance, and no H1N1 training was provided ahead of time. A triple-redundancy coding method was used to prevent underreporting of calls. This allowed the Texas poison centers to accurately flag over 90% of H1N1 cases. Results were available in real time, allowing day-to-day monitoring by poison centers and the state public health department for surges, location, ages of callers and/or patients, and type of question.?Conclusion.?The accuracy of poison center near real-time toxicosurveillance data coding was sufficient to monitor emerging trends. The data generated by poison centers are flexible, immediate, unique from other data sources, and useful for trend monitoring. As health departments and other collaborative partners rely more on the data from poison centers, consideration must be given to appropriate funding to support coding training, monitoring, and quality assurance to further enhance this valuable system.

This commentary should have been published alongside the following article: Coding of influenza A H1N1 virus calls received by Texaspoison centers Mathias B. Forrester and Jeanie E. Jaramillo Clinical Toxicology, Vol. 48, No. 4: 359–364.     

In the hospital setting, what is the patient's role?

It is crucial for all medical institutions to maximize the selection of their actors in strict accordance to equality. As medical administrators, were are questioned on the problems linked with compartmentalization. Our investigation has allowed us to confirm that the ensemble of actors, including the patient, regulates compartmentalization, and that all in all it works rather well. However, this regulation has a price. It has an impact on organization, the energy used, not to mention the cumbersome side-effects that would be felt. We have chosen to focus our research on the patient's role on regulation by using his/her testimony. The patient is never passive. Adaptation requires real efforts on the patient's part in order to adapt to this new environment, while at the same time economizing his/her strength. The regulation carried out is often standardized. The patient conforms, but against his/her will. Does the patient's admittance to the hospital make him/her a second-class citizen? Our results lead us to believe that the prevailing views advocate that the patient be at the heart of the system remain an objective.     

Culture, ethnicity, race: what's the difference?

Culture can be seen as a dynamic, ever-changing process. When caring for children and families from diverse backgrounds nurses need to be able to accomodate differences willingly and competently. Do not be afraid to ask--you cannot know everything about someone else's culture. Every unit/team should have contact details of advocates, translators, and local leaders whose support the family may desire, and have information available in other languages which explain the terminology used by healthcare professionals. Nurses can show respect by being available and accessible and by not imposing their own beliefs or agendas.