中风病急性期中医护理路径实施观察

[目的]探讨中风病中医护理路径用于中风病急性期病人的效果。[方法]将78例中风病急性期病人随机分为观察组40例和对照组38例,观察组采用中医临床护理路径护理,对照组采用中医常规护理方案,连续21d后评价疗效。[结果]观察组病人疗效、病人满意度均明显高于对照组(P0.05)。[结论]中风病急性期中医护理路径在临床应用后,效果可靠,病人满意。     

中风病急性期中医护理路径实施观察

[目的]探讨中风病中医护理路径用于中风病急性期病人的效果。[方法]将78例中风病急性期病人随机分为观察组40例和对照组38例,观察组采用中医临床护理路径护理,对照组采用中医常规护理方案,连续21d后评价疗效。[结果]观察组病人疗效、病人满意度均明显高于对照组（P〈0．05）。[结论]中风病急性期中医护理路径在临床应用后,效果可靠,病人满意。     

家庭护理对精神分裂症病人康复的临床影响

[目的]探讨家庭护理对精神分裂症病人康复的临床影响。[方法]选择2015年2月—2018年1月诊治的精神分裂症病人96例为研究对象,并按照护理方案不同分组:对照组48例根据护理常规接受出院指导,研究组48例应用家庭护理干预,就两组病人精神分裂症康复效果、健康行为养成率以及护理满意度进行统计学分析。[结果]护理后两组病人精神分裂症阳性症状量表评分均低于护理前,其中研究组低于对照组(P0.05);研究组病人健康行为养成率97.92%,较对照组的83.33%高(P0.05);研究组病人的护理满意度100.00%高于对照组的89.58%(P0.05)。[结论]家庭护理对精神分裂症病人康复有正性影响,可提高康复效果,并帮助病人养成健康行为习惯,且护理满意度较高。     

中医护理方案在脑梗死急性期后风痰上扰证眩晕护理中的应用研究

[目的]探讨脑梗死急性期后风痰上扰证眩晕的中医护理方案临床实施效果。[方法]选择脑梗死急性期后风痰上扰证眩晕病人80例,随机分为两组各40例,对照组给予脑病科常规护理;观察组在常规护理基础上,实施针对性的中医护理方案。比较两组病人住院时间、日常生活活动能力、临床护理效果、依从性、满意度。[结果]干预组病人日常生活活动能力评分为(80.32±9.49)分、临床护理总有效率为97.5%,高于对照组[(56.30±7.04)分、62.5%];病人对中医护理技术依从性、满意度均优于对照组;住院时间短于对照组,两组比较差异均有统计学意义(P0.05)。[结论]中医护理方案能有效改善脑梗死急性期后风痰上扰证眩晕症状。     

艾灸联合中医辨证护理干预对脑卒中急性期便秘病人的影响

[目的]探讨实施艾灸联合中医辨证护理干预脑卒中急性期病人便秘的效果。[方法]将2013年5月—2014年10月在我科住院68例脑卒中急性期便秘病人随机分为两组,每组34例,对照组根据医嘱给予常规护理,观察组运用中医辨证护理方法,根据证型使用艾灸联合饮食、情志等干预措施实施辨证施护,观察两组病人便秘护理效果。[结果]对照组有效率73.5%,观察组有效率94.1%,两组比较差异有统计学意义(P0.05)。[结论]艾灸联合中医辨证护理可有效改善脑卒中急性期病人便秘症状,对脑卒中康复有积极作用。     

Orem自护理论结合辨证施护模式在脑卒中后遗症病人中的应用

[目的]探讨Orem自护理论结合辨证施护应用于脑卒中后遗症病人居家康复的实用性及有效性。[方法]对122例脑卒中后遗症病人及其家庭进行综合干预,制定护理方案和评价体系,实施辨证施护与自我护理,观察病人家庭生活质量及康复情况,采用居家病人护理需求评估量表、Barthel指数评定。[结果]122例脑卒中后遗症家庭护理需求分值明显降低（P〈0.05）;Barthel指数评分明显提高（P〈0.05）;对护理工作模式的满意度随着干预时间的延长明显提高（P〈0.05）。[结论]建立Orem自护理论与辨证施护工作模式能明显提高脑卒中后遗症病人及其家庭的自护能力、康复进度、社区护理工作的满意度和护理工作效率。     

卒中急性期病人中医综合康复护理效果观察

[目的]探讨中医综合康复护理对卒中急性期病人神经功能缺损及日常生活能力(ADL)的影响。[方法]选择2004年9月—2006年9月在3家协作医院住院的卒中急性期238例病人为研究对象,随机分为实验组和对照组,两组药物治疗基本相同。实验组按中医综合康复护理方案进行护理,对照组采用卒中护理常规进行护理。对入选的病人在入院第1周内和4周后进行神经功能缺损及ADL的评定。[结果]4周后实验组在临床神经功能缺损、ADL等方面明显优于对照组,差异有统计学意义(P<0.01)。[结论]中医综合康复护理可促进肢体的功能恢复,提高病人的ADL。     

脑梗死急性期中医护理方案临床应用效果评价

[目的]探讨脑梗死急性期中医护理方案临床应用效果。[方法]选取2015年3月—2015年8月在我院治疗的脑梗死急性期病人60例,按入院先后顺序编号,单号为对照组,双号为观察组。对照组给予常规护理,观察组在对照组基础上实施中医护理方案,比较两组病人治疗前后Barthel指数评分、疗效。[结果]观察组病人治疗后Barthel指数评分为(52.7±3.1)分,对照组为(43.9±2.6)分,两组比较差异有统计学意义(P0.05);观察组总有效率为90.0%,对照组总有效率为63.3%,两组比较差异有统计学意义(P0.05)。[结论]脑梗死急性期中医护理方案的实施有助于提升病人生活自理能力,改善病人肌张力,提高生活质量。     

Orem自护理论结合辨证施护模式在脑卒中后遗症病人中的应用

[目的]探讨Orem自护理论结合辨证施护应用于脑卒中后遗症病人居家康复的实用性及有效性。[方法]对122例脑卒中后遗症病人及其家庭进行综合干预,制定护理方案和评价体系,实施辨证施护与自我护理,观察病人家庭生活质量及康复情况,采用居家病人护理需求评估量表、Barthel指数评定。[结果]122例脑卒中后遗症家庭护理需求分值明显降低(P<0.05);Barthel指数评分明显提高(P<0.05);对护理工作模式的满意度随着干预时间的延长明显提高(P<0.05)。[结论]建立Orem自护理论与辨证施护工作模式能明显提高脑卒中后遗症病人及其家庭的自护能力、康复进度、社区护理工作的满意度和护理工作效率。     

脑卒中偏瘫病人康复期中西医结合护理的康复效果观察

[目的]观察脑卒中偏瘫病人康复期中西医结合护理的康复效果。[方法]将70例脑卒中偏瘫病人随机分为观察组与对照组各35例,两组病人实施西医康复护理对策,观察组联合应用中医情志护理、膳食调节以及穴位按摩护理。评价两组病人生活自理能力以及临床治疗效果。[结果]观察组病人各项生活自理能力评分均高于对照组病人(P0.05);观察组病人治疗总有效率为94.29%,高于对照组病人的77.15%(P0.05)。[结论]脑卒中偏瘫病人康复期实施中西医结合护理,有助于提升病人的生活自理能力,提高临床治疗效果。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.