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Bowel management--particularly digital rectal examination (DRE) and the manual removal of faeces--has been a contentious issue for some time. In the past few years this has been brought to the fore by a number of cases of professional misconduct by nurses. 相似文献
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Madhotra D Fenton JE Makura ZG Charters P Roland NJ 《Irish journal of medical science》2004,173(4):197-199
Background The timing of aggressive airway intervention in adult epiglottitis is controversial.
Aims To correlate Friedman’s staging of epiglottitis on admission with the airway interventions undertaken.
Methods A retrospective study of 23 adult patients, mean age 51 years (range 29–81 years), who had been admitted with acute supraglottitis
between March 1988 and December 2000 was undertaken.
Results Three patients (13%) had airway interventions; two with tracheostomy and one with tracheal intubation. All were Friedman
stage III and had rapid symptom progression during the 24 hours prior to admission. Three other stage III patients with symptom
progression longer than 24 hours and all the remaining patients (stage II or less) were managed with observation and intravenous
therapy.
Conclusions Friedman originally advocated airway intervention in any patient stage II or worse, but this intubation threshold should
probably be lowered to those patients with rapid-onset stage III (moderate respiratory distress, stridor, respiratory rate
>30 per minute, pCO2 >45mmHg) disease. 相似文献
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AM Pierides HA Ellis H Dellagrammatikas JE Scott AW Norman 《Archives of disease in childhood》1977,52(6):464-472
Three children with azotaemic renal osteodystrophy were treated with 1,25-dihydroxycholecalciferol (1,25(OH)2D3). All showed clinical, biochemical, and radiological improvement within 6 months of starting treatment. There were no complications. The dose of 1,25(OH)2D3 required was 0-5 microgram per day for 2 children aged 22 and 30 months, and 2 microgram per day for a 15-year-old boy. 2 of the patients were receiving phenobarbitone and phenytoin and in one of them prior treatment with dihydrotachysterol 0-5 mg daily and 6 microgram 1alpha-hydroxycholecalciferol (1alphaOHD3) daily had failed to induce improvement. In one patient, in whom serial iliac bone samples were available, 2 microgram 1,25(OH)2D3 resulted in histological improvement in previously severe osteomalacia. 1,25(OH)2D3 appears to be an effective and safe drug in the treatment of uraemic osteodystrophy. 相似文献
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