止泻散敷脐治疗婴幼儿腹泻100例

0　引言　腹泻乃小儿最常见病 ,尤以 2岁以下婴幼儿最为常见 .年龄越小 ,发病率越高 ,且多在夏、秋季发病 .小儿患病后惧怕打针 ,服药以及输液 ,给治疗带来一些困难 . 12 a来 ,我们用自拟的止泻散敷脐治疗婴幼儿泄泻 ,效果良好 .1　对象和方法1.1　对象　 1998- 0 6 / 1999- 10婴幼儿腹泻发病高峰期门诊病例 10 0 (男 6 6 ,女 34 )例 ,年龄 2月龄～ 5岁 .肠炎 5 8例 ,单纯消化不良 42例 . 6 7例曾多次治疗 ,33例初诊 .凡接受治疗之患儿 ,一律停止用其他药物 .1.2　方法　药物组成 :川椒 12 g,干姜 12 g,小茴香 12 g,白芷 2 0 g,吴茱萸 5 g,…     

Premature infants in car seats: effect of sleep state on breathing

SUMMARY  Previous studies have shown that premature infants may be at risk for hypoxemia and bradycardia when placed in standard car seats. However, the relationship of such breathing abnormalities to sleep state have not been studied. The purpose of the present study was to investigate the effect of car seat positioning on respiratory patterns in preterm infants during sleep and to evaluate their relationship to sleep state. Complete polysomnography, including sleep and breathing parameters, was performed on twenty-eight premature infants. Each infant was randomly assigned to the car seat or prone (crib) position for the first recording period. Following the recording of at least two sleep cycles, the position was reversed. The percentage of active and quiet sleep was calculated and breathing parameters were measured. In the car seat, the infants spent significantly more time in active sleep and less time in quiet sleep than in the prone position, of the respiratory parameters, periodic breathing (PB) was significantly higher in the car seat. The presence of at least one abnormal breathing events (bradycardia, desaturation, PB apnoea) was also significantly higher in the car seat. An analysis of variance (ANOVA) of PB revealed significant sleep-state effect (active vs. quiet sleep), but no significant condition or interaction effects, indicating that PB was more frequent in active sleep regardless of the sleeping condition. It is concluded that increased active sleep in the car seat condition, rather than the positioning of the infant in the seat per se, may account for the increase in periodic breathing and possibly other breathing abnormalities reported in car seats.     

A “flipped” kidney in utero in an infant with a double collecting system and a Gartner's duct cyst with a vaginal ectopic ureter

We report an infant with two unique anatomic abnormalities. A flipped kidney in utero is described with the association of a Gartner's duct cyst and a vaginal ectopic ureter with a duplicated collecting system.     

Purtscher-like retinopathy associated with pancreatic adenocarcinoma

PURPOSE: To investigate a case of Purtscher-like retinopathy that occurred in association with pancreatic adenocarcinoma. METHOD: Case report. RESULTS: A 63-year-old woman presented with multiple gray patches in the central vision of both eyes. Visual acuity was 20/20 in both eyes. Funduscopy showed large peripapillary yellow-white patches within the superficial retina and small superficial retinal hemorrhages in both eyes. The patient subsequently had abdominal pain. Computed tomography of the abdomen demonstrated a large pancreatic mass with extension into the liver. Histologic examination of a percutaneous needle biopsy specimen showed mucinous pancreatic adenocarcinoma. CONCLUSION: Pancreatic adenocarcinoma should be added to the list of systemic diseases that can be associated with Purtscher-like retinopathy.     

The linearity of the volume/pressure response during intracranial pressure "reserve" testing.

The intracranial pressure "reserve" test seems to be the most reliable method of determining when the brain''s natural mechanisms for pressure compensation for added intracranial volume have been compromised or exhausted. The test employs a timed sequence of intracranial fluid injections, but as a safety precaution injections are discontinued if intracranial pressure remains elevated more than 10 Torr over baseline. In this case, a linear extrapolation is then calculated to determine the elevation which might have been achieved by a full series of injections. However, this linear extrapolation has been criticised on the expectation that an exponential response should be expected. A series of experimental observations in dogs and baboons and a review of clinical records in humans have been made to determine the observed slope of increase following aliquot injection during performance of the intracranial pressure reserve test. In these species the observed response was actually linear in shape rather than exponential. This held true even for different initial baseline values and with different volumes of "lesion" balloon inflations in experimental animals. A theoretic explanation is proposed.     

Evolving a blueprint for certification: the responsibilities and knowledge comprising American professional oncology nursing practice.

Ensuring adequate content validity of a certification examination is a major concern in the development and administration of a test. To establish content validity of the Oncology Nursing Certification Corporation (ONCC) certification exam, a job analysis study was conducted to provide empirical data about the responsibilities and knowledge areas required for practice at the level of the newly certified oncology nurse. The study involved The Profession of Oncology Nursing: An Inventory of Responsibilities and Knowledge (IRKPON), a questionnaire that was developed based on a review of the literature, professional practice information, interviews with oncology nurses, the original ONCC certification exam table of specifications, and evaluations undertaken by two advisory committees. The IRKPON consisted of three parts: 56 responsibilities clustered into eight job dimensions, 217 knowledge areas grouped into seven knowledge dimensions, and demographic information. The IRKPON was sent to a stratified random sample of 3,000 oncology nurses in the United States, who were asked to rate both the responsibilities and knowledge areas by level of importance. The 1,297 (43%) responding nurses rated 45 of 56 responsibilities (80.4%) as "very important" and 8 of 56 responsibilities (14.3%) as "extremely important"; they also rated 163 of 217 knowledge areas (75.1%) as "very important" and 41 of 217 knowledge areas (18.9%) as "extremely important." These findings identified the specific responsibilities most important to the oncology nurse role at the level of the newly certified nurse, as well as the knowledge areas necessary for competent performance. Subsequent ONCC certification examinations were modified; the test blueprint that guides the construction of the examination was revised, and the passing score was adjusted.     

Incidence of apnoea and bradycardia in preterm infants following DTPw and Hib immunization: A prospective study

Objective: To evaluate the incidence and severity of apnoea and bradycardia in hospitalized preterm infants following immunization at 2 months of age, and identify risk factors.
Methodology: A prospective study of 98 preterm infants, of gestational age 24–31 weeks, immunized at approximately 2 months post natal age with diphtheria-tetanus-whole cell pertussis vaccine (DTP_w) in the neonatal intensive care unit (NICU) at King George V Hospital Sydney. Half the infants also received Haemophilus influenzae type b conjugate vaccine (Hib) simultaneously. All infants were monitored for apnoea and bradycardia in the 24 h periods pre- and post immunization.
Results: Only one infant had apnoea and/or bradycardia pre-immunization compared with 17 post immunization. For 12 infants these events were brief, self-limiting and not associated with desaturations (oxygen saturation <90%). However, for five infants (30%) these events were associated with oxygen desaturation and two of these infants required supplemental oxygen. The group that had apnoea and/or bradycardia and the group that did not were not significantly different in terms of gestational age, birth weight and other variables. Infants who received Hib together with DTP_w were less likely to have apnoea and/or bradycardia than those given DTP_w alone.
Conclusion: When considering immunization for preterm infants, the benefits of early immunization must be balanced against the risk of apnoea and bradycardia. We recommend that the cardio-respiratory function of hospitalized infants born at less than 31 weeks gestation be monitored for 48 h post immunization.