透空散治疗顽固性头痛92例

2004年以来，我们用古代民间验方改良剂透空散治疗顽固性头痛92例，取得了满意效果，现报道如下。     

Antibiotic prescribing for chronic skin wounds in primary care

The aim of this study was to describe and quantify systemic antibiotic prescribing for patients with chronic skin wounds presenting at the primary care, nonspecialist setting. Data for 1 year were extracted from a general practice morbidity database comprising approximately 185,000 patients attending family medical practitioners in Wales. Patients with chronic wounds (PCW) were identified using Read Codes and compared with nonwound patients who were randomly selected after matching for age-band, sex, and general practice. PCW received a significantly greater number of antibiotic courses than nonwound patients (p<0.001). This increased level of prescribing was evident for flucloxacillin, co-amoxiclav, cefaclor, cefalexin, erythromycin, trimethoprim, metronidazole, and ciprofloxacin (p<0.01 for all). While PCW also had a significantly higher prevalence of diabetes (16.5% compared with 6.6%, p<0.001), and attended at general practice significantly more frequently than nonwound patients (median (interquartile range) of 25 (17-40) visits per year compared with 12 (4-20), p<0.001), importantly, exclusion of diabetic patients and analysis of the proportion of visits on which patients received antibiotics did not affect the significance of the difference in antibiotic consumption. These data show a strong association between occurrence of chronic wounds and prescribing of antibiotics in primary health care, and wide variation in the type and duration of antibiotic therapy for chronic wounds. Further work is now indicated to rationalize this prescribing and determine the role that this exposure to antibiotics plays in the prevalence of antibiotic resistance in this at-risk elderly population.     

Acinetobacter skin abscess in a neonate.

Although Acinetobacter is usually a species of low virulence, it is becoming increasingly more important as a cause of hospital outbreaks, particularly on intensive care units. Antibiotic resistance can develop rapidly. This organism has not been reported to cause skin abscesses previously. We describe a case of a neonate who developed an Acinetobacter abscess on our neonatal intensive care unit.     

Binocular sensory outcomes in accommodative ET

PURPOSE: To review what is known about the normal maturational sequence for fusion and stereopsis and the binocular sensory deficits associated with accommodative esotropia (ET) and to explore the clues that accommodative ET provides about critical periods for binocular sensory function. METHODS: Studies of binocular sensory function during infancy and early childhood are presented. RESULTS: Most of the maturation of binocular sensory function occurs during the first year of life, yet a later abnormal visual experience-such as the onset of accommodative ET--can profoundly and permanently disrupt fusion and stereopsis. CONCLUSIONS: Some binocular sensory deficits may exist before the onset of accommodative ET, but others may result directly from abnormal binocular experience. The functional organization of the maturing visual system appears to be maximally sensitive to disruption by abnormal visual experience during the first months of life, but susceptibility continues until at least 4 years of age.