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22.
Amy Tinney MSN FNP-C CPM LM Elizabeth Rice ND DHANP 《Journal of Midwifery & Women's Health》2023,68(Z1):S1-S19
A substantial proportion of adults and children in the United States use complementary and alternative health practices, including homeopathy. Many homeopathic therapies are readily available over the counter, and many individuals access and self-administer these therapies with little or no guidance from health care practitioners. In addition, patients and health care providers are often confused by terminologies associated with complementary practices and may be unable to distinguish homeopathy from naturopathy, herbalism, holistic medicine, Ayurveda, traditional Chinese medicine, or other forms of health care. Compared with European and Asian countries, education in the United States about complementary and alternative health practices is not typically found within traditional nursing, midwifery, or medical education curricula. Given this lack of education and the broad acceptance and popularity of homeopathy, it is necessary for health care practitioners to improve their knowledge regarding similarities and differences among therapies so they can fully inform and make appropriate recommendations to patients. The intent of this article is therefore to examine the state of existing science of homeopathy, distinguish it from other complementary methods, and provide midwives and women's health care providers with an introduction to common homeopathic therapies that may be recommended and safely used by persons seeking midwifery care. This review also presents the evidence base, pharmacology, manufacturing, and regulation of homeopathic therapies. We also consider controversies and misunderstandings regarding safety and efficacy of homeopathic remedies relevant to women and birthing persons. Examples of practical applications of homeopathic therapies for use in midwifery practice are introduced. Implications for practice and sample guidelines are included. 相似文献
23.
Acute bronchial obstruction by mucous plugs may be manifested clinically by dyspnea, hypoxemia, and respiratory alkalosis mimicking pulmonary thromboembolism. In eight cases with complete interruption of ventilation to an entire lung, chest radiography failed to reveal the extent of the obstruction. Perfusion was substantially less affected than ventilation. Routine ventilation-perfusion scintigraphy with technetium-99m DTPA aerosol aids in the diagnosis of acute major bronchial obstruction in patients with suspected pulmonary thromboembolism. 相似文献
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25.
Severe malaria in children in Papua New Guinea 总被引:1,自引:0,他引:1
Allen SJ; O'Donnell A; Alexander ND; Clegg JB 《QJM : monthly journal of the Association of Physicians》1996,89(10):779-788
The clinical features of severe falciparum malaria and risk factors for
mortality were studied in 489 children admitted with malaria to Madang
Hospital, Papua New Guinea. The most common severe manifestations of
malaria were severe anaemia (22%) and coma (16%). Children with severe
anaemia were younger than those with coma (median age 2.2 vs. 3.7 years)
and had been ill for longer before admission (median 7 vs. 4 days,
respectively). Although the clinical features of coma in Madang children
with malaria resembled closely those reported in African children,
mortality was lower (8% vs. 17-25%, respectively). Overall, 17 (3.5%)
children died, most within 12 h of admission. A high level of plasma
lactate (> or = 5 mmol/l) was common (20%) and was the major predictor
of death in multiple regression analysis. Raised plasma creatinine and
decreased plasma bicarbonate were also independent predictors of mortality.
Coma was not predictive of death, although a high proportion of children
with profound coma died. Investigation of the causes of acidosis in
children with malaria is a high research priority. In view of the short
time interval between admission and death in many children, emphasis must
be placed on the prevention or early recognition and treatment of acidosis
in the district health clinic as well as the central hospital.
相似文献
26.
Patterns of Depressive Symptoms in Children 总被引:1,自引:0,他引:1
Mary K. Bailey ND APN RN Jaclene A. Zauszniewski PhD RN-BC FAAN Marjorie M. Heinzer PhD APRN BC CRNP Marion Hemstrom-Krainess DNSc RN CS 《Journal of child and adolescent psychiatric nursing》2007,20(2):86-95
PROBLEM: Depressive symptoms in children have been linked to recurrent problems with depression, school problems, and risky health behaviors. Adolescent girls report depressive symptoms three to four times more frequently than adolescent boys. Few studies, however, have examined gender-related depressive symptoms in younger, school-aged children. METHODS: In the present study, gender differences in depressive symptoms in children ages 10-12 years were explored using the Children's Depression Inventory (CDI) with a convenience sample of 122 suburban middle-class public school fifth and sixth graders. FINDINGS: A distinct pattern of depressive symptom expression was found with girls reporting more internalizing and more negative self-esteem, and boys reporting more externalizing and more school problems. CONCLUSION: These findings suggest that despite similarities on a total depressive symptom score, there are distinct gender differences in depressive symptom expression that are identifiable before adolescence and may be associated with normative development. 相似文献
27.
28.
A Pareek SD Zawar SB Salagre NB Chandurkar ND Karnik 《European journal of medical research》2009,14(7):297-303
Objective
High blood pressure is one of the most important risk factors, directly responsible for increasing the cardiovascular morbidity and mortality. The primary objective was to evaluate the efficacy of metoprolol XL/chlorthalidone against metoprolol XL/hydrochlorothiazide with respect to mean fall in systolic and diastolic blood pressure. The secondary objective was to compare the response rates and to evaluate the tolerability of study medications in patients with mild-tomoderate essential hypertension.Methods
Total 130 eligible patients (65: metoprolol XL 25 mg/chlorthalidone 6.25 mg; 65: metoprolol XL 25 mg/HCTZ 12.5 mg) were enrolled in this randomized, comparative, multicentric, 12-weeks study. Sixty-two patients from each group completed the study. After 4-weeks of treatment, non-responders from chlorthalidone 6.25 mg combination group were shifted to metoprolol XL 50 mg/chlorthalidone 12.5 mg and non-responders from HCTZ 12.5 mg combination group were escalated to metoprolol XL 50 mg/HCTZ 12.5 mg.Results
The study treatment groups were comparable with respect to demography and baseline disease characteristics. Both the starting therapies were comparable with respect to mean fall in SBP (p = 0.788) and DBP (p = 0.939), and response rates (p = 1.0) after 4-weeks of therapy. Also both the step-up therapies showed similar mean fall in SBP (p = 0.277) and DBP (p = 0.507) at the end of 12-weeks. However, significantly more number of patients from chlorthalidone 12.5 mg/metoprolol XL 50 mg group responded to therapy as compared to that from HCTZ 12.5 mg/metoprolol XL 50 mg group (p = 0.045). All the reported adverse events were of mild-to-moderate intensity. There were no clinically significant trends in electrolytes (Na+, K+, Cl-)and fasting blood sugar, evident across the treatment groups.Conclusion
Chlorthalidone in combination with metoprolol XL is as effective and well tolerated as widely used combination of metoprolol XL/HCTZ, thus providing an alternative therapeutic option. 相似文献29.
G M Galstian V M Gorodetski? L Iu Tikhonova L L Speranskaia L N Gotman E E Mirzoian E N Glasko R G Kuliev T N Rybalkina L F Evseeva 《Terapevticheski? arkhiv》1999,71(7):33-39
AIM: To characterize clinical, diagnostic and course features of pneumonia caused by Pneumocystis carinii (PC) in hematologic inpatients. MATERIALS AND METHODS: 27 patients with blood diseases were studied. 22 of them had acute respiratory insufficiency and 5 had unclear lung affection. The data from bronchoalveolar lavage (BAL), lung biopsy, serum tests for IgG, IgM anti-PC-antibodies were used for diagnosis of PC-pneumonia. RESULTS: PC-pneumonia was diagnosed in 8 of 27 patients. Clinical manifestations characteristic for PC-pneumonia were not found. In 5 patients the diagnosis was made on the evidence provided by BAL. Lymphocyte count in BAL was elevated to 27.7 +/- 8.7%. Open biopsy of the lung and transbronchial biopsy diagnosed PC-pneumonia in 2 and 1 patients, respectively. Previous BAL examinations failed to detect PC-pneumonia in 2 of them. In all the patients PC-pneumonia was associated with another infection (bacterial, cytomegaloviral). Histologically, the picture of the disease was determined by the severity of the lung affection or its complications. 5 of 8 patients failed treatment with trimethoprim-sulphamethoxazole and died. Marked respiratory insufficiency was registered at PC-pneumonia diagnosis in all the lethal cases. CONCLUSION: Clinical and x-ray pictures of PC-pneumonia in hemoblastosis patients are not specific. All such patients with symptoms of lung infection resistant to antibacterial and antifungal therapy should be examined for PC-pneumonia. 相似文献
30.
M. E. Platonov V. V. Evseeva S. V. Dentovskaya A. P. Anisimov 《Molecular Genetics, Microbiology and Virology》2013,28(2):41-51
The present review is focused on methods of Yersinia pestis genotyping that are reproducible in different laboratories and allow for differentiation of individual bacterial isolates into intraspecies groups corresponding to subspecies, biovars, and natural foci. A variant of the intraspecies classification of Y. pestis compliant with the rules of the International Code of Nomenclature of Bacteria is presented. 相似文献