Family-based intervention to enhance infant-parent relationships in the neonatal intensive care unit

OBJECTIVE: To examine how family-based interventions in the neonatal intensive care unit (NICU) may change parental knowledge and behaviors and decrease stress. METHODS: Eighty-four high-risk mother-infant dyads were randomly assigned to two intervention and one control groups. Group 1 (n = 28) participated in a demonstration of infant reflexes, attention, motor skills, and sleep-wake states. Group 2 (n = 31) viewed educational materials. Group 3 (n = 25), controls, participated in an informal discussion. Parent-infant interactions (Nursing Child Assessment Feeding Scale) were videotaped. Mothers completed measures of stress (Parenting Stress Index) and knowledge of infant cues (Knowledge of Preterm Infant Behavior Scale). RESULTS: Mothers in both intervention groups evidenced greater knowledge and more contingent and sensitive interactions with their infants than did the control group. Stress also differed across groups, and all mothers reported scores above norms. CONCLUSIONS: In a high-risk sample, short-term, family-based NICU interventions may enhance mothers' knowledge, sensitivity, contingency, and stress.     

Recurrent hemoptysis with Penicillium marneffei and Stenotrophomonas maltophilia in Job’s syndrome

Pulmonary infection caused by the opportunistic organisms Penicillium marneffei and Stenotrophomonas maltophilia in patients with Job’s syndrome is rare and not well documented. The case of a 30-year-old man with Job’s syndrome who developed recurrent pneumonia and lung abscesses caused by P marneffei and S maltophilia, complicated by massive hemoptysis, is described. Bronchial artery embolization was successful in controlling the hemoptysis; however, the infection proved fatal despite appropriate antimicrobial therapy. A brief review of the literature on Job’s syndrome and its associated infective pulmonary manifestations is also presented.     

军队离退休老干部健康状况调查分析

1对象和方法 1．1对象 兰州军区驻兰10个干休昕和体系单位离退休老干部786名,其中男性719名,占91％,女性67名,占9％,年龄67～93（平均74）岁．     

Coronoidectomy in maxillary swing for reducing the incidence and severity of trismus--a reminder.

PURPOSE: The maxillary swing approach is a proven method for access to the nasopharynx. However, often, trismus is incurred postoperatively, hampering adequate oral care and follow-up and affecting patients' quality of life. CASE REPORTS: Coronoidectomy was performed in four patients undergoing maxillary swing. Minimal trismus was seen in one patient undergoing repeat irradiation and chemotherapy. After a 1-month period no trismus was observed in the other three patients. CONCLUSION: Coronoidectomy, usually performed in maxillectomy for reducing trismus is a useful adjunct in the maxillary swing procedure.     

Developmental Supports for Newborns and Young Infants with Special Health and Developmental Needs and Their Families: The BABIES Model

Fragile newborns and young infants who are born with a likelihood of lingering developmental concerns require specialized assessment and intervention based on their unique developmental needs. Often these infants are identified as categorically eligible for early intervention and nursing services, based on their medical condition at birth. The medical involvement of many of these infants adds complexity to the evaluation and/or provision of services, let alone how to best provide supports for their families. Increasing data regarding the regulatory disorganization of young infants which leads to later cognitive and mental health challenges provide a rationale for appropriate assessment and intervention strategies for this population. A recent survey of educational needs of Colorado professionals working with this population revealed that many early intervention providers felt only “slightly” prepared to evaluate newborns and young infants and that most providers felt they could benefit from more training on assessment and intervention with this population. Best practice for this increasing population includes specialized and evidence-based training and capacity building necessary to prepare professionals to evaluate, intervene, and support their unique fragility and emerging developmental competencies. The current study describes the development and components of the BABIES approach to supporting early intervention professionals and nurses to best integrate relationship based developmental supports for fragile newborns and young infants.     

Are pelvic radiographs needed in assault victims?

To determine the incidence of acute pelvic fractures in patients with a history of being assaulted. Retrospective review by two musculoskeletal radiologists of 357 consecutive patients in a 12-month period, (308 males, 49 females). Two hundred seventy-six patients also had pelvic CT scans done at the same time. There were no acute pelvic fractures in this group. One patient had a 12th rib fracture and two other patients had a total of three lumbar spine transverse process fractures at the L1, L2, and L5 levels. Pelvic radiographs are not needed as part of standard protocols for patients who present with a history of being assaulted.     

Merkel cell carcinoma of unknown primary site

Merkel cell carcinoma is an uncommon and aggressive primary neuroendocrine skin malignancy which mostly affects the extremities and the head and neck region of elderly patients. Merkel cell carcinoma occurs with increased frequency in sun-exposed areas, in individuals exposed to arsenic and in immunosuppressed patients. Many patients with Merkel cell carcinoma present with other malignancies, mainly skin cancers. Characteristic features are frequent recurrences and regional and distant metastases. Mortality rates range from 20 to 65 per cent. The mainstay of treatment is surgery, with wide local excision, and adjuvant radiotherapy is usually administered. Merkel cell carcinoma of unknown primary site is rare, and the majority of the few cases described have not been from head and neck areas. We present a case of Merkel cell carcinoma of unknown primary site, with upper neck and distant metastases.