High frequency ultrasound‐guided pericardiocentesis performed in the sitting position: A novel apical approach

BackgroundSo far, few approaches have been described to reduce inadvertent injury to structure of the heart and nearby organs in percutaneous pericardiocentesis.HypothesisWe hypothesized that an in‐plane high frequency ultrasound‐guided apical approach, performed in the sitting position, would provide additional benefits in terms of feasibility and safety for draining malignant pericardial effusion (MPE).MethodsThe authors selected 53 consecutive patients with moderate or large symptomatic MPE who underwent high frequency ultrasound‐guided pericardiocentesis. After the procedure, all patients were followed for 90 days with the main purpose of detecting procedure success, procedure‐related complications, and recurrent PE.ResultsProcedure success rate for pericardiocentesis was 100%. All patients were placed in the sitting position with their left hands extended above the heads. An apical puncture approach was performed in all cases (100%). The mean duration of catheter drainage was 8.1 ± 3.2 days. The mean initial amount of pericardial fluid drained was 956.3 ± 687.5 ml. Overall, six patients (11%) had recurrent PE; 3 (6%) had repeated percutaneous pericardiocentesis. There was no major complication and minor complications occurred in four patients (8%).ConclusionThis novel in‐plane high frequency US‐guided apical approach has several advantages for percutaneous pericardiocentesis of MPE: performed in the sitting position; a benefit for patients with orthopnea; a maximum inserted wide angle to prevent damage to the myocardium; local enlargement of the PE region; high procedure success rate of pericardiocentesis; and excellent clinical outcomes.     

Sitting Time and Obesity or Abdominal Obesity in Older South Koreans: Korean National Health and Nutrition Examination Survey 2013

We examined relationships between sitting time and obesity or abdominal obesity according to sex and socioeconomic status in elderly people. We analyzed data from the Korean National Health and Nutrition Examination Survey 2013, and 1565 participants were included in the study. Multivariate logistic regression analysis was used to examine relationships between sitting time and obesity or abdominal obesity according to sex and socioeconomic status. Sitting time was positively correlated with body mass index in men and women and waist circumference in men. When considering socioeconomic factors, men who sat for 5 hours or longer and fell within the lowest income were more likely to have obesity and abdominal obesity relative to men who sat for 5 hours or shorter and earned higher incomes (odds ratio [95% confidence interval] = 1.80 [1.14–2.84] and 1.63 [1.02–2.61] respectively), and women who sat for 5 hours or longer and fell within the lowest educational level were more likely to have obesity relative to women who sat for 5 hours or less and were educated to a higher level (1.24 [1.01–1.85]). Strategies to reduce sedentary behavior would help to prevent obesity in older men who earn low incomes and women with lower levels of educational attainment.     

坐式体位对产妇镇痛分娩的影响

目的探讨坐式体位对产妇镇痛分娩的影响。方法在获得研究对象知情同意后,便利抽样法选取2013年3-7月在绍兴市妇幼保健院住院实施硬膜外镇痛分娩的99例产妇作为研究对象,按随机数字表法将其分为观察组(n=52)和对照组(n=47)。观察组产妇采用坐式体位进行分娩,对照组产妇采用传统的仰卧位进行分娩,观察两组产妇分娩方式、第二产程、产妇舒适度、下肢酸胀麻木及会阴切开等指标。结果观察组产妇自然分娩率为98.08%,明显高于对照组的85.11%,差异有统计学意义(χ2=3.982,P=0.046);第二产程所用时间明显少于对照组,差异有统计学意义(t=2.310,P=0.024);产妇分娩舒适度总体好于对照组,差异有统计学意义(Z=-2.049,P=0.040);产妇发生下肢酸胀麻木和会阴切开的比例均低于对照组,差异均有统计学意义(均P0.05)。结论坐式体位分娩可提高产妇自然分娩率、缩短第二产程时间和提高产妇分娩舒适度。     

健康教育结合坐位调膝法治疗膝骨关节炎临床观察

摘要：目的：观察健康教育结合坐位调膝法治疗膝骨关节疼痛和屈伸不利的临床疗效。方法：选择2018年01月-2018年12月到医院治疗的膝关节病患者120例,治疗组60例运用针对性的健康教育手册结合坐位调膝法,对照组60例采用常规功能康复教育和温针治疗。采用HSS评分系统评价临床疗效和VAS评分系统评价即刻镇痛效果,观察患者首次治疗前后关节疼痛分值和疗程结束后临床疗效分值。结果：两组治疗后,患者首次治疗后,治疗组关节内、外侧VAS评分（3.74±1.65）和（5.03±1.27）,明显低于对照组的（6.7±1.52）和（6.98±1.86）,有统计学意义（P<0.05）,疗程结束后治疗组的临床总有效率为100%,明显高于对照组的60%,治疗组HSS临床疗效评分（73.2±4.80）,明显高于于对照组的（59.6±8.09）,有统计学意义（P<0.05）。结论：健康教育结合坐位调膝法对膝骨关节炎有更加积极的治疗作用,有利的促进膝关节各项功能的恢复,值得临床推广。     

A study of two sitting positions in frail,older, non‐mobile and totally dependent residents of aged care facilities

Objectives: To determine the effect of two ‘sitting‐out’ positions among frail, elderly, non‐mobile and totally dependent aged care residents. Methods: Ten frail elderly women older than 75 years undertook evaluation. Oxygen saturation, blood pressure and heart rate were measured in reclined (< 25 degrees from horizontal) and upright (> 75 degrees from horizontal) sitting to determine the change in these parameters induced by position. Results: There was a significant increase in oxygen saturation (P = 0.000) systolic (P = 0.000) and diastolic blood pressure (P = 0.034) and heart rate (P = 0.000) when subjects were moved from the reclined sitting position to upright sitting. The recordings were sustained during the measuring periods independent of position. There was no evidence of postural hypotension induced in the upright sitting position. Conclusions: Results indicate the superiority of the upright sitting position for potential tissue oxygenation. Adopting the upright sitting position may enable participation in functional activities, thereby improving quality of life.     

自拟坐盆汤坐浴治疗慢性非细菌性前列腺炎55例疗效观察

目的:探讨自拟坐盆汤坐浴治疗慢性非细菌性前列腺炎的临床疗效。方法:将100例符合条件的患者随机分成治疗组55例,对照组45例。治疗组采用坐盆汤加温水坐浴治疗;对照组采用温水坐浴。2组均每日1次,10次为1个疗程。结果:治疗3个疗程后,治疗组临床症状明显好转,免疫抑制因子(IAP)量明显上升,与对照组比较均有显著性差异(P<0.001)。结论:自拟坐盆汤坐浴治疗慢性非细菌性前列腺炎有一定疗效。     

Reliability and validity of the modified functional reach test at the sub-acute stage post-stroke

Objectives. The first aim of this study was to evaluate the within-session reliability of sitting balance measures by assessing forward and lateral reach while sitting in both healthy subjects and patients post- stroke. The second aim was to evaluate the ability to document change in reaching while sitting over time in patients post-stroke. The third aim was to compare sitting balance results by the modified functional reach test (MFRT) to the Balance Master (BM), motor and function assessments.

Design. Data were collected on two occasions: Two to three weeks post-event and again six weeks later. On each occasion within-session reliability was tested using the intra-class correlations (ICC). The tests were performed three times; the second and third attempts were compared in order to test the within-session reliability. For assessing the concurrent validity, the MFRT results were compared with the BM results, Stroke Assessment Scale (SAS) and the Functional Independence Measure (FIM) score using Pearson correlations.

Setting. In-patient rehabilitation department.

Participants. Patients after a first ischemic stroke 14 – 21 days post-event were recruited from the inpatient rehabilitation department at Hadassah University Hospital, Jerusalem, Israel. Excluded were patients with brain stem lesions and/or bilateral signs or hemorrhagic events as diagnosed by Computerized Tomography, patients with Mini-Mental State Examination < 20, those who were not able to sit unsupported for 10 sec and those who could stand without support for more than 30 sec.

Main Outcome Measures. The MFRT, performed while sitting in forward and sideward directions.

Results. The MFRT in all directions on both occasions exhibited high reliability (intra-class correlation coefficient range, 0.90 – 0.97). The responsiveness to the paretic side was high (effect size 0.80) and moderate for the forward and non-paretic side (effect size 0.57 – 0.60). A significant moderate correlation was found between MFRT and BM on both occasions.

Conclusion. The MFRT while sitting can be reliably measured and may serve as a useful outcome measure in individuals with stroke 2 – 8 weeks post-event.