老年高血压的临床特点及治疗策略

高血压严重影响老年人的健康,是老年人发生脑卒中、冠心病、心肌梗塞、充血性心衰、肾功能衰竭等疾病的主要危险因素之一。但我国高血压病的预防率、控制率、治疗率均较低,并且发病率、并发症及死亡率高。本文就老年高血压的特点及治疗作一综述,旨在为老年高血压患者的临床诊治提供一定帮助。     

Affective communication deficits associated with cerebellar degeneration

The cerebellum has extensive connections with the frontal lobes. Cerebellar injury has been reported to induce frontal-executive cognitive dysfunction and blunting of affect. We examined a patient with idiopathic cerebellar degeneration with impaired family relationships attributed to an “emotional disconnection.” Examination revealed ataxia, dysmetria, and adiadochokinesia more severe on the left and frontal-executive dysfunction; memory and cognitive functions were otherwise normal. Testing of emotional communication included assessments of emotional semantic knowledge, emotional prosody, and emotional facial expressions. Comprehension was normal but expression was severely impaired. Cerebellar dysfunction can cause a defect in facial and prosodic emotional communication.     

Proposed strategies for successful clinical management with aripiprazole

Background: Aripiprazole is an effective medication for treating patients with schizophrenia and bipolar disorder , and as an adjunct in patients with major depressive disorder and an inadequate response to antidepressant treatment, that is generally safe and well tolerated. Despite its potential clinical benefits, the management of aripiprazole-treated patients can be challenging due to the lack of a simple dosing strategy and guidelines for preventing and managing potential adverse effects. Objective: Two initiation/dosing strategies with aripiprazole are presented that are based on the overall symptom profile rather than specific clinical diagnosis: a rapid titration/high-dose strategy and a slow titration/low-dose strategy. Methods: The dosing strategy recommendations are based on clinical experience and a PubMed database search conducted with no date restrictions for English-language literature. Keywords included aripiprazole, dose switching or strategy, schizophrenia or bipolar disorder and adverse effects. Conclusions: Two strategies have been designed to help clinicians tailor aripiprazole therapy to the specific needs of individual patients and manage common adverse effects that may be encountered during therapy.     

Economics of MRI Operations After Implementation of Interpersonal Skills Training

PurposeExamine the cost of MRI operations before and after implementation of interpersonal skills training to reduce unanticipated patient-related events in an academic medical center.MethodsTeams at four MRI sites (two hospital-based, two freestanding) were trained in evidence-based communication skills in February to April 2015. Training was designed to enable staff members to help patients mobilize their innate coping skills in response to any distress they experienced during their MRI visit. Data were collected before training and afterward from January to June 2016. Staff reported the incidence of disruptive motion, sedation use, MRI delays, incomplete examinations, and no-shows. Cost and revenue associated with MRI operations and staff and physician costs were estimated using Medicare and private insurance rates and data from the US Bureau of Labor Statistics.ResultsThe study included 12,930 outpatient MRI visits. From baseline to follow-up, average monthly patient volume increased from 1,105 to 1,463 at hospital MRI sites and from 245 to 313 at freestanding MRI sites. Patient factors necessitating sedation or interfering with image progression or quality decreased from 9.0% to 5.5% at hospital sites and from 3.1% to 1.2% at freestanding sites. These changes translated into a reduction in operational costs of $4,600 per 1,000 scheduled patients and an increase in profit of $8,370 per 1,000 scheduled patients in hospital MRI sites, and a corresponding increase in operational costs of $1,570 per 1,000 scheduled-patients and an increase in profit of $12,800 per 1,000 scheduled patients in freestanding MRI sites.ConclusionsWe found significant improvements in MRI operational efficiency after interpersonal skills team training, which were associated with reductions in costs and growth in revenue.     

Improving evoked response audiometry

Normative studies were carried out with 8 adult subjects whose averaged evoked responses to auditory stimuli were scored visually and by a number of differently defined quantitative methods (machine scoring). In order to compare different scoring methods a common signal-to-noise ratio measure was introduced based on a model where noise is distributed normally and signal is additive. Visual and machine scoring proved to be approximately equally sensitive, but the latter lends itself to a superior testing procedure which takes only one-third as long for equivalent results and is not contaminated by subjective error. The authors believe that the greatest promise for improving evoked response audiometry lies in the exploration of the new techniques proposed earlier. Progress in proving out one of these techniques, fast periodic stimulation, is reported.     

AIDET沟通联合六西格玛管理在改善床边快速血糖疼痛感中的应用

目的 观察AIDET 沟通联合六西格玛管理在改善床边快速血糖疼痛感中的应用效果。方法 选取2019 年1—6 月在本院内分泌科住院的糖尿病患者94 例，运用AIDET 沟通模式联合六西格玛管理方法作为改善工具，改善前患者为对照组，纳入48 例，改善后患者为观察组，纳入46 例，比较两组患者即时疼痛评分、24 h 后疼痛评分、左右手疼痛评分、各手指疼痛评分的情况及改善前后患者主观资料的变化。结果 观察组患者床边快速血糖的即时及24 h 后NRS 评分均低于对照组，差异有统计学意义（P<0.05）；与即时相比，两组患者24 h 后左右手NRS评分比较，差异均有统计学意义（P＜0.05）；观察组患者24 h 后的NRS 评分明显低于对照组，差异有统计学意义（P＜0.05）。两组患者主观资料中的知识、无想法比例比较，差异有统计学意义（P<0.05）。结论 运用AIDET 沟通联合六西格玛管理模式改善床边快速血糖疼痛感，可以有效的减轻患者疼痛感，体现了优质护理中人文关怀的理念。     

浅谈广告策略在非处方药市场中的重要性

OTC市场已成为制药企业获得经济收益的重要市场之一.由于OTC是一种特殊的消费品,因此广告策略在营销过程中起着举足轻重的作用.合理运用广告策略,是制药企业在这一市场获得成功的关键.