Treatment appraisals and beliefs predict adherence to complementary therapies: A prospective study using a dynamic extended self‐regulation model

Objectives Complementary and alternative medicine (CAM) is used by large numbers of the general public and is increasingly becoming integrated into the mainstream. An understanding of why people use CAM in general has been developed in the literature, but relatively little is known specifically about adherence to CAM. We tested hypotheses (derived from a dynamic extended version of Leventhal's common‐sense model) that patients' beliefs about treatment, perceptions of illness, and treatment appraisals would predict adherence to CAM. Design A prospective self‐report questionnaire study was carried out with a 3‐month follow‐up period. Methods A total of 240 patients from five CAM clinics completed self‐report questionnaire measures of treatment beliefs, illness perceptions, and treatment appraisals at baseline. Three months later, they completed self‐report measures of adherence to therapists' recommendations concerning attendance, remedy use, and life‐style changes. Results Logistic regression analyses showed that positive perceptions of one's therapist and belief that mental factors do not cause illness independently predicted adherence to appointments. Positive beliefs in holistic health and finding it difficult to travel to appointments predicted adherence to remedy use. Using homeopathy was the only independent predictor of adherence to life‐style changes. Conclusions Treatment appraisals, treatment beliefs, and illness perceptions explain modest proportions of the variance in adherence to CAM. This study highlights the value of operationalizing the appraisal element of the common‐sense model when investigating adherence to treatment.     

无创颅内压监测仪临床应用中N2波的特点

目的:目前无创颅内压监测仪尚未在临床得到广泛和熟练应用,总结无创颅内压监测仪临床应用中的N2波形特点,为今后的工作提供指导意义。方法:①实验对象:选取2006-01/2007-01珠江医院神经外科住院颅脑损伤患者50例,分成3组,其中颅内血肿急诊手术组20例,颅内血肿保守治疗后加重再手术组10例,颅内血肿保守治疗组20例,以及正常对照组20例。均对本实验知情同意。②主要实验仪器:应用MICP-1A型无创颅内压监测仪(重庆名希公司),闪光眼罩,所产生的光源为蓝色氖光,闪光刺激频率1.0Hz,闪光脉冲宽度2ms,闪光次数70次(1次/s),枕部电极和额部电极。③实验评估:前两组分别监测手术前后颅内压闪光视觉诱发电位值,共3次,后两组在相应时间分别测定闪光视觉诱发电位值,每次监测颅内压后即刻腰穿测定颅内压进行对照。闪光视觉诱发电位颅内压监测时,15min内连续3遍测定闪光视觉诱发电位值并记录,取平均值,分析所记录240幅闪光视觉诱发电位的N2波,总结N2波特点,比较同一测试者随着颅内压的改变闪光视觉诱发电位值的变化情况。结果:闪光视觉诱发电位的N2波监测的颅内压结果和腰椎穿刺测定的颅内压结果等效(P>0.05),设定等效界值为0.098kPa(10mmH2O)。颅内血肿组闪光视觉诱发电位值均高于正常对照组(P<0.05)。在同一测试者,多次测量也可得出不同的波形,N2波的变化趋势稳定,N2波波幅与颅内压无关,N2波较宽,其波形的一个主要特点是前后均有较深的P波。颅内压越高N2波潜伏期越长。结论:闪光视觉诱发电位的值和腰穿测定颅内压结果基本接近,可以直接反应出颅内压的改变趋势,尽管N2波形变化较大,但是还是有规律可循,N2波的中点潜伏期可以作为测量颅内压的依据。     

Multidrug resistant Psudomonas aeruginosa infections complicating surgical wounds and the potential challenges in managing post–operative wound infections: University of Calabar Teaching Hospital experience

ObjectiveTo ascertain the antimicrobial susceptibility profile of Pseudomonas aeruginosa (P. aeruginosa) recovered from surgical site infections (SSIs).MethodsThe study was retrospective in nature and was compiled for a period of five years (1st February, 2004–31st January, 2009). Data were generated from the culture of post-operative wound swab specimens by the microbiology laboratory of University of Calabar Teaching Hospital. Relevant information from the patients' records was compiled, such as age, gender, type of surgical procedure, microorganisms recovered and their antibiotic sensitivity patterns. Obtained data was analysed by using Epi Info 6 statistical software.ResultsOf the 4 533 wound swab specimens processed, 673 were culture positive and P. aeruginosa was recovered from 13.1% of the culture positive specimens with its rate of recovery decreasing with age progression (P< 0.05) but with no gender difference (P> 0.05). Most of the P. aeruginosa isolates were from general surgery wards and least from orthopaedic wards. Ofloxacin, ceftriaxone and augmentin were the most active antibiotics while ampicillin, tetracycline and cotrimoxazole were the least active antibiotics, with no antibiotic having a 100% activity against the organism.ConclusionsIn view of the high resistance displayed by P. aeruginosa recovered from SSIs, adequate antiseptic procedures should be entrenched to avoid colonization of surgical wounds by this microorganism as well as others with similar sensitivity profile. Ofloxacin, ceftriaxone and augmentin may be considered for prevention of P.aeruginosa infection.     

Characterization of novel akermanite:poly‐ϵ‐caprolactone scaffolds for human adipose‐derived stem cells bone tissue engineering

In this study, three different akermanite:poly‐?‐caprolactone (PCL) composite scaffolds (wt%: 75:25, 50:50, 25:75) were characterized in terms of structure, compression strength, degradation rate and in vitro biocompatibility to human adipose‐derived stem cells (hASC). Pure ceramic scaffolds [CellCeram^TM, custom‐made, 40:60 wt%; β‐tricalcium phosphate (β‐TCP):hydroxyapatite (HA); and akermanite] and PCL scaffolds served as experimental controls. Compared to ceramic scaffolds, the authors hypothesized that optimal akermanite:PCL composites would have improved compression strength and comparable biocompatibility to hASC. Electron microscopy analysis revealed that PCL‐containing scaffolds had the highest porosity but CellCeram^TM had the greatest pore size. In general, compression strength in PCL‐containing scaffolds was greater than in ceramic scaffolds. PCL‐containing scaffolds were also more stable in culture than ceramic scaffolds. Nonetheless, mass losses after 21 days were observed in all scaffold types. Reduced hASC metabolic activity and increased cell detachment were observed after acute exposure to akermanite:PCL extracts (wt%: 75:25, 50:50). Among the PCL‐containing scaffolds, hASC cultured for 21 days on akermanite:PCL (wt%: 75:25) discs displayed the highest viability, increased expression of osteogenic markers (alkaline phosphatase and osteocalcin) and lowest IL‐6 expression. Together, the results indicate that akermanite:PCL composites may have appropriate mechanical and biocompatibility properties for use as bone tissue scaffolds. Copyright © 2012 John Wiley & Sons, Ltd.     

巢式逆转录-聚合酶链反应扩增人骨形成蛋白2全长cDNA及其真核表达载体的构建

目的:利用巢式逆转录-聚合酶链反应扩增的方法,从肌肉组织中扩增人骨形成蛋白2全长cDNA并构建真核表达载体系统。方法:实验于2003-10/2005-10在苏州大学基因工程教研室和北京大学第三医院骨科实验室完成。提取成人肌肉组织内的总RNA,设计内外两对引物以巢式逆转录-聚合酶链反应扩增方法分两次扩增出人骨形成蛋白2全长1188bp基因,经T-A克隆装入pUCM-T质粒载体内,测序验证后,将克隆质粒以Hind Ⅲ和Xba Ⅰ双酶切后与pcDNA3.0载体相连接,构建真核表达载体系统。结果:利用巢式逆转录-聚合酶链反应扩增方法能从成人肌肉组织内扩增出1188bp的人骨形成蛋白2全长cDNA基因,其测序结果显示与Genebank报道序列完全相符。将扩增序列双酶切后与pcDNA3.0载体相连接,经电泳验证,能构建人骨形成蛋白2全长基因的真核表达系统。结论:巢式逆转录-聚合酶链反应扩增方法能从成人肌肉组织内扩增出人骨形成蛋白2全长cDNA基因,并克隆构建真核表达载体系统,为下一步基因组织工程人工骨实验奠定基础。