暖贴加热法在溶解甘露醇结晶中的应用观察

目的 探讨暖贴加热法溶解甘露醇结晶在临床应用中的可行性.方法 选择2012年10月至2013年4月期间结晶的甘露醇400袋,按单双号随机分成对照组和试验组,各200袋.对照组采用温水浸泡溶解的方法,试验组采用贴暖贴加热溶解的方法,观察比较两种不同方法甘露醇结晶的溶解时间、输注过程中再次析出结晶的例数及出现局部疼痛或静脉炎等情况.结果 与对照组比较,试验组溶解甘露醇结晶时间均明显缩短、温度保持时间延长、输注过程再次析出结晶的例数减少、局部刺激疼痛和静脉炎发生率明显降低,差异有统计学意义（P＜0.05）.结论 暖贴加热法溶解甘露醇结晶操作简单、方便快捷、安全可行、并发症少、应用效果显著,值得在临床推广应用.     

Hypersensitivity myocarditis complicating hypertrophic cardiomyopathy heart

The present report describes a case of eosinophilic myocarditis complicating hypertrophic cardiomyopathy. The 47-year-old female patient, known to have hypertrophic cardiomyopathy, was admitted with biventricular failure and managed aggressively with dobutamine infusion and other drugs while being assessed for heart transplantation. On transthoracic echocardiogram, she had moderate left ventricular dysfunction with regional variability and moderate mitral regurgitation. The recipient's heart showed the features of apical hypertrophic cardiomyopathy and myocarditis with abundant eosinophils. Myocarditis is rare and eosinophilic myocarditis is rarer. It is likely that the hypersensitivity (eosinophilic) myocarditis was related to dobutamine infusion therapy. Eosinophilic myocarditis has been reported with an incidence of 2.4% to 7.2% in explanted hearts and may be related to multidrug therapy.     

Solitary diverticulum of the cecum and right colon

Diverticulum of the cecum is a rare, benign, generally asymptomatic lesion that manifests itself only following inflammatory or hemorrhagic complications. A personal series of six cases discusses the difficulty of differential diagnosis at both the preoperative and intraoperative levels. The preferable treatment is simple resection.     

Two novel SNPs in the promoter region of PKR gene in hepatitis C patients and their impact on disease outcome and response to treatment

Background and study aims

The double-stranded RNA dependent protein kinase (PKR) plays a vital role in the immune system. During HCV infection, PKR has antiviral effect by inhibition of protein synthesis of the HCV. The functional single nucleotide polymorphisms (SNPs) in PKR promoter region might have a relation to HCV disease outcome and response to treatment. The objective of the present work was threefold. First, it proposed an optimized protocol for PCR amplification of PKR promoter. Second, it screened the promoter region of PKR gene in HCV Egyptian patients to detect the possible SNPs’ function. Third, to study the association between the detected SNPs and the response to treatment.

HCV Infection in Egyptian Patients with Acute Hepatitis

The diagnostics of community-acquired acute HCVhepatitis in an endemic area was studied in 110 Egyptianpatients with acute jaundice. In the first week of thejaundiced period 30 of 110 patients (27.3%) had anti-HCVantibodies. The majority already showed high levels ofanti-HCV IgG (25/30), associated with anti-HCV IgM innine of them. Five patients showed only an HCV IgMreactivity. Seven had also anti-HEV and/or anti-HBV: their jaundice couldthen be related to an acute infection caused by thoseviruses. All patients were infected with genotype 4a, inthree associated with the 3a. During the follow-up five patients seroconverted for IgG, whiletheir anti-HCV IgM did not show a uniform pattern ofreactivity. Patients with positive serology suspected ofan acute HCV infection were older than the patients with other acute hepatitis and showed a lowerpeak of ALT level. Seroconversion during acute hepatitisstrongly indicated HCV as the etiologic agent. However,the detection of anti-HCV IgG antibodies in the jaundiced period showed that the majorityof patients had already seroconverted to anti-HCVantibodies; in most of them it is possible tohypothesize a reactivation of a chronic HCVinfection.     

Residents from non‐English‐speaking countries of birth in Australian aged care facilities

Objective

To describe the activity of daily living and behavioural and complex care needs of residents born in non‐English‐speaking countries in Australian aged care facilities.

Methods

De‐identified cross‐sectional data were provided by the Australian Institute of Health and Welfare for all residents in government‐funded facilities on 30 June 2015. Analyses included t‐tests, chi‐squared tests and logistic regressions.

Results

A total of 33 168 (19%) residents were born in one of 188 non‐English‐speaking countries. Compared to residents born in English‐speaking countries, they were significantly younger, lived in larger facilities, were more likely to be male and live in an urban area. Their care requirements were greater for activities of daily living and behavioural and complex care. Residents from non‐English‐speaking countries living in ethno‐specific facilities had higher levels of these needs.

Conclusion

The needs of residents born in non‐English‐speaking countries should be considered when planning aged care services.

     

Help seeking in older Asian people with dementia in Melbourne: Using the Cultural Exchange Model to explore barriers and enablers

The prevalence of dementia is increasing in Australia. Limited research is available on access to Cognitive Dementia and Memory Services (CDAMS) for people with dementia from Culturally and Linguistically Diverse (CALD) communities. This study aimed to determine the barriers and enablers to accessing CDAMS for people with dementia and their families of Chinese and Vietnamese backgrounds. Consultations with community members, community workers and health professionals were conducted using the “Cultural Exchange Model” framework. For carers, barriers to accessing services included the complexity of the health system, lack of time, travel required to get to services, language barriers, interpreters and lack of knowledge of services. Similarly, community workers and health professionals identified language, interpreters, and community perceptions as key barriers to service access. Strategies to increase knowledge included providing information via radio, printed material and education in community group settings. The “Cultural Exchange Model” enabled engagement with and modification of the approaches to meet the needs of the targeted CALD communities.