A simple mnemonic,B.U.R.N.S., for burns first aid

IntroductionBurn injuries remain common in the world, with an average of more than thousands of cases requiring medical attention each year. Singapore sees an average of 220 burns admissions annually. Given the high number of burn cases in Singapore, the authors identified that there is a need for more public awareness on first aid burn treatment. Acute management of burns can improve eventual patient outcome. The authors devised a simple mnemonic that can be used in burns education for first aid treatment, intended to be taught to trained personnel, who will have the first contact with these burn patients. The aim of the study was to assess the viability of implementing this mnemonic, B.U.R.N.S, to facilitate first aid education for burns.Material and methodsIn this study, we presented this mnemonic as a poster to 30 full-time burn care medical professionals. Feedback was then obtained from this group of medical professionals and used to revise the mnemonic. The mnemonic was then subsequently taught to 400 medical professionals, who are predominantly involved in the pre-hospital management of burns. They are then asked to reiterate the mnemonic to test the ease of remembering the mnemonic. Objective feedback was obtained with a 5-point scoring system.ResultsThe results indicated a significant improvement in burn first aid knowledge after the implementation of the mnemonic, from a score of 3.67–4.77, The content was deemed as appropriate and easy to understand and recall, and participants were able to reiterate the content, and will recommend this mnemonic to be used for burns teaching for first aid.ConclusionThe study results suggest that this B.U.R.N.S. mnemonic and visual aid is simple and easy to apply, especially for uniformed personnel, as these individuals may have the first contact with the burns victims, and it is important for them to render the appropriate burns first aid treatment. Overall, burns first aid awareness and education can be improved with the implementation of this mnemonic and poster. Moving forward, we aim to integrate the B.U.R.N.S. into educational programmes in professional institutions involved in responding to burns (medical and nursing schools of Singapore), as well as in schools and public institutions, for educational purpose to raise public awareness. We wish to also be able to do so on an international level when courses are conducted.     

Association between gravidity and risk of metabolic syndrome: Results of Tabari cohort study

Background and aimsThe purpose of the present study was to investigate the association of gravidity and age at first pregnancy with metabolic syndrome in a large-scale, population-based cohort study in Iran.MethodsThe present secondary analysis was conducted on a subset of the population (5739 women with at least one pregnancy) enrolled in the Tabari cohort study. Reproductive history was collected using a structured questionnaire. The relationship of gravidity and age at first pregnancy with metabolic syndrome and its components was analyzed using the logistic regression model.ResultsThe results showed that after adjustment for confounding variables, the odds of having metabolic syndrome was not significantly associated with age at first pregnancy (P = 0.269) and gravidity (P = 0.504). However, there was an association between hypertension and age at first pregnancy (OR = 0.32, 95% CI = 0.12–0.82; P = 0.03). Additionally, waist circumference was also associated with gravidity (OR = 2.17, 95% CI = 1.37–3.35).ConclusionAs the findings indicated, age at first pregnancy and gravidity were not associated with the odds of having metabolic syndrome. However, a relationship was found between first pregnancy at the age of >35 years and the decreased risk of hypertension. Gravidity was also found to be a dose-dependent risk factor for increased waist circumference.     

Cortical mechanisms underlying variability in intermittent theta-burst stimulation-induced plasticity: A TMS-EEG study

ObjectiveTo test the hypothesis that intermittent theta burst stimulation (iTBS) variability depends on the ability to engage specific neurons in the primary motor cortex (M1).MethodsIn a sham-controlled interventional study on 31 healthy volunteers, we used concomitant transcranial magnetic stimulation (TMS) and electroencephalography (EEG). We compared baseline motor evoked potentials (MEPs), M1 iTBS-evoked EEG oscillations, and resting-state EEG (rsEEG) between subjects who did and did not show MEP facilitation following iTBS. We also investigated whether baseline MEP and iTBS-evoked EEG oscillations could explain inter and intraindividual variability in iTBS aftereffects.ResultsThe facilitation group had smaller baseline MEPs than the no-facilitation group and showed more iTBS-evoked EEG oscillation synchronization in the alpha and beta frequency bands. Resting-state EEG power was similar between groups and iTBS had a similar non-significant effect on rsEEG in both groups. Baseline MEP amplitude and beta iTBS-evoked EEG oscillation power explained both inter and intraindividual variability in MEP modulation following iTBS.ConclusionsThe results show that variability in iTBS-associated plasticity depends on baseline corticospinal excitability and on the ability of iTBS to engage M1 beta oscillations.SignificanceThese observations can be used to optimize iTBS investigational and therapeutic applications.     

院前急救对急性出血性脑卒中患者的影响

目的:分析和探讨院前急救对急性出血性脑卒中患者预后及死亡率的影响。方法:选取急诊科150例急性出血性脑卒中患者,其中107例经院前急救给予心电监护、吸氧、镇静、脱水降颅压等初步处理后送往石景山医院急诊科就诊,43例自行来院(未经任何处理,由家属直接送入医院)。对两组患者进行分析比较。结果:107例患者经过院前急救,预后良好率37.4%,植物生存率9.3%,死亡率5.6%;而其余43例患者预后良好率11.6%,植物生存率32.6%,死亡率23.2%。院前急救在争取院内救治时间、降低病死率和神经系统并发症等方面均具有显著的作用和效果。结论:及时有效的院前救治大大降低了急性出血性脑卒中的植物生存率和病死率,对于进一步提高抢救成功率和预后生存质量起到了至关重要的作用。     

综合护理干预对老年股骨颈骨折患者术后首次排便的影响

目的探讨综合护理干预对老年股骨颈骨折患者术后首次排便的影响。方法便利抽样法选择2010年11月至2011年11月在镇江市第二人民医院住院治疗的84例老年股骨颈骨折需手术的患者为研究对象,按随机数字表法将其分为观察组和对照组,每组42例。观察组患者采用综合护理干预措施,对照组采用骨科常规护理措施,观察比较两组患者术后自觉肠鸣音时间、肛门排气时间、首次排便时间以及首次大便通畅度情况。结果观察组患者术后自觉肠鸣音时间、肛门排气时间、首次排便时间均早于对照组,且首次大便通畅度优于对照组,差异均有统计学意义(均P<0.01)。对照组有24例术后96h仍未排便,给予通便药物或灌肠干预,而观察组仅有1例患者需灌肠干预。结论综合干预措施能明显缩短老年股骨颈骨折患者术后肠功能恢复时间。     

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??Objective??To study the influence of the inlay on the stress of the remained tooth tissue??three-dimensional finite element is used to analyse stress distributions of the tooth endured different MOD inlay restore at different remaining buccal wall thickness. Methods??Using ANSYS Workbench 15.0 software to established 3d finite element model of mandibular first molar restored by all-ceramic inlay restoration with designed MOD cavities. Analyzing the influences of different remaining buccal wall thickness to the stress distribution and tendency of the teeth. Results??Different remaining buccal wall thickness of the tooth tissue on the stress level had a certain influence??the lowest stress level was the remaining buccal wall thickness of 2 mm. The stress level of occlusal coverage restoration was higher than inlay restoration. Conclusion??The study found that different remaining buccal wall thickness of the tooth tissue on the stress level have a certain influence??try to keep healthy dentine??avoid enamel without foundation is effective means of inlay restoration reducing the risk of tooth fracture. Remaining more tooth tissue is not suggested to restore occlusal coverage.