Determinants of dietary intake during childhood diarrhea and implications for appropriate nutritional therapy

Diarrheal diseases have a well recognized negative effect on children's growth, probably due in part to reduced dietary intake during illness. Previous studies have shown that the effects of diarrhea on dietary intake are greater among hospitalized children than among those observed in their homes. Breast milk intake does not change during diarrhea, however, so breast-fed children are less likely to reduce their total energy and nutrient intakes. Recent analyses of clinical studies found that acidosis and dehydration were most closely associated with reduced dietary intake of hospitalized patients. The implications of these and other studies for the dietary management of patients during and after diarrhea are discussed.     

介入治疗并发症的发生与防治

介入治疗是融合了内科药物治疗、外科手术治疗及医学影像学的一种特殊的治疗体系 ,其疗效受到世人瞩目并成为目前发展最为迅速的学科之一。但是 ,再好的方法也会存在不足之处 ,介入治疗也不例外。随着介入治疗在各家医院的普遍应用 ,并发症的发生也会越来越多 ,迫使人们关注这个问题。所谓介入治疗并发症 ,是指因血管造影及 (或 )血管内治疗所引起、需要一定治疗、使病人的治疗复杂化或延长病人住院时间的不良反应 ,就其全身多系统而言 ,介入治疗引发并发症的原因大致可归纳为两个主要因素即介入器材操作和引入人体内的物质(包括介入治疗所…     

烧伤创面切削痂植皮对纠正烧伤后肾脏损害的价值

目的　探讨烧伤合并肾脏损害的治疗方法。方法　对 47例烧伤合并肾损害进行烧伤创面切削痂植皮 ,以减少烧伤毒素、促进创面修复、促进肾脏功能恢复。结果　术后 1周观察 ,3 6例肾损害治愈、9例好转、2例无效 ;完成手术后 ,最快 3d肾损害即可控制。本组最后治愈41例、死亡 6例。结论　对于烧伤合并肾损害 ,及时采用手术治疗 ,不仅利于肾功能的恢复 ,也是保证患者最终康复的重要手段。一旦烧伤病人出现肾功能损害 ,应尽早进行烧伤创面切削痂植皮术修复深度创面。     

颅内后循环远端动脉瘤的介入治疗

目的回顾性分析20例以电熔断解脱弹簧圈栓塞的后循环远端动脉瘤的治疗结果,探讨颅内动脉后循环远端动脉瘤的介入治疗方法与安全性。方法20例患者(其中18例以自发性蛛网膜下腔出血起病,2例以头痛起病)经造影证实大脑后动脉、小脑上动脉、小脑前下动脉、小脑后下动脉之远端动脉瘤分别为2例、4例、4例、10例。其中小脑上动脉供血之动静脉畸形1例,伴有血流相关破裂动脉瘤。小脑后下动脉远端多发动脉瘤1例。所有动脉瘤均采用GDC、EDC或Matrix弹簧圈栓塞。其中单纯栓塞动脉瘤2例;栓塞动脉瘤同时栓塞载瘤动脉18例。结果所有病例栓塞操作均顺利完成,无手术相关的死亡,术后出现一过性功能障碍2例;载瘤动脉栓塞后多数可见侧支供血,未见叫显的小脑供血减少。结论后循环远端动脉瘤由于动脉瘤特性、载瘤动脉细小、动脉瘤与载瘤动脉比例等因素,多需要闭塞载瘤动脉。为避免可能造成的侧支血管的闭塞,建议用弹簧圈栓塞。     

Recovery from depression after electroconvulsive therapy is accompanied by evidence of increased tetrahydrobiopterin-dependent hydroxylation

Serum phenylalanine and tyrosine levels were measured in 26 patients with severe depression before and after receiving electroconvulsive therapy. The phenylalanine:tyrosine [P:T] ratio declined significantly for those responding to treatment but not for nonresponders. These findings are discussed in relation to tetrahydrobiopterin, the essential cofactor for the formation of noradrenaline, dopamine and serotonin and the hydroxylation of phenylalanine to tyrosine.     

Near visual acuity: a simple measure of practical significance in insulin-treated diabetic patients.

The value of measuring near visual acuity as a predictor of loss of independence in administering insulin and monitoring blood or urine glucose has been assessed in 110 insulin-treated diabetic patients. Near visual acuity was simple to measure in the clinic setting, and correlated well with 6 m acuity. Fourteen patients depended on an assistant either to draw up the correct dose of insulin (n = 12), inject the insulin (n = 7) or to monitor blood or urine glucose (n = 12). Of these 14 patients only one, who was demented, had near visual acuity better than N.12. Two other patients had near visual acuity N.12 or worse and yet were independent of help. One had severe visual impairment and used a pen-injector and a meter with speech synthesizer, and the other had near visual acuity of N.12. Impairment of near visual acuity to N.12 or worse is associated with loss of independence in insulin-treated diabetes. Measurement of near visual acuity could be useful in predicting independence of insulin-treated patients.     

法莫替丁治疗消化性溃疡60例

60例(男50,女10,年龄43±8a)经内窥镜证实的活动性消化性溃疡患者,口服法莫替丁40mg,qn,疗程2-4wk或延至6-9wk。溃疡愈合率DU2,4,6 wk分别为50％,84％,92％,SU2,4,6,8 wk分别为40％,68％,73％,82％。服药后3,7,14 d上腹痛缓解率DU为50％,80％,100％,SU为40％,75％,95％。未见严重不良反应。故法莫替丁对溃疡病,尤其是DU是一有效和安全药物。     

Irritable bowel syndrome: The role of psychosocial factors

The irritable bowel syndrome (IBS) is a very common disorder of intestinal function characterized by variable symptoms of abdominal pain, diarrhea, constipation and bloating. The spectrum of severity ranges from mild symptoms, not worthy of clinical attention, to intense and continuous symptoms associated with impaired health-related quality of life and high health care use. Psychosocial disturbance is commonly found among patients with irritable bowel, but until recently, its precise role in the disorder was uncertain. The data now suggest that irritable bowel is not a psychiatric disorder per se, but psychosocial factors including life stress, psychiatric comorbidity and abnormal illness behavior, among others, influence how the illness is experienced and acted upon. Patients with mild symptoms usually respond to education, reassurance, dietary modification and, when needed, antimotility agents. However, patients with more severe symptoms, who usually have greater psychosocial disturbance, will also require behavioral interventions, and possibly psychopharmacological agents. In sum, a graduated, multicomponent plan of care that includes dietary, behavioral and pharmacological treatments is recommended.     

Consistent control of psoriasis by continuous long-term therapy: the promise of biological treatments

Psoriasis is a chronic, incurable disease that frequently requires long-term treatment. Although many patients benefit from effective traditional systemic therapies, namely methotrexate, cyclosporin, retinoids and fumaric acid esters, and some patients achieve long-term disease control, unrestricted long-term administration is not recommended due to the potential for cumulative toxicity. In order to diminish the risk of toxicity, physicians have adopted various treatment approaches (e.g. rotational, sequential, intermittent, and combination). However, these approaches may not provide continuous disease control or a stable treatment regimen. The recent advent of targeted biological therapeutics such as etanercept, infliximab, adalimumab, alefacept and efalizumab may offer physicians and their patients treatment options with improved safety profiles that may permit continuous disease control.