Plasma Exchange Versus Double Filtration Plasmapheresis in the Treatment of Guillain‐Barré Syndrome

Abstract: Previous studies have shown that both plasma exchange (PE) and double filtration plasmapheresis (DFPP) are effective treatments in Guillain‐Barré syndrome (GBS). Whether PE and DFPP have similar effects in GBS is not clear. This report compares the therapeutic effectiveness of PE and DFPP in GBS patients treated in 3 major hospitals in northern Taiwan. A total of 102 patients were included in this survey, including 39 with PE (hereafter PE group) and 63 with DFPP (hereafter DFPP group). Both groups showed significant improvement of disability scores after treatment. However, time to onset of effect was shorter (5.6 ± 3.5 versus 7 ± 3.4 days, p < 0.05), and changes of disability scores were more prominent (1.3 ± 0.8 versus 0.8 ± 0.8, p < 0.05) in the PE group than the DFPP group. Mortality and outcome after 6 months were not different between the 2 groups. In conclusion, both PE and DFPP are effective treatments in GBS. PE was superior to DFPP in short‐term effectiveness. The long‐term effectiveness was not different.     

Uso de la infusión intestinal continua de levodopa-carbidopa en pacientes con enfermedad de Parkinson avanzada en España. Subanálisis por comunidades autónomas

ObjectivesTo compare the characteristics of patients undergoing treatment with continuous intestinal infusion of levodopa-carbidopa (CIILC) for advanced Parkinson's disease and the data on the effectiveness and safety of CIILC in the different autonomous communities (AC) of Spain.MethodsA retrospective, longitudinal, observational study was carried out into 177 patients from 11 CAs who underwent CIILC between January 2006 and December 2011. We analysed data on patients’ clinical and demographic characteristics, variables related to effectiveness (changes in off time/on time with or without disabling dyskinesia; changes in Hoehn and Yahr scale and Unified Parkinson's Disease Rating Scale scores; non-motor symptoms; and Clinical Global Impression scale scores) and safety (adverse events), and the rate of CIILC discontinuation.ResultsSignificant differences were observed between CAs for several baseline variables: duration of disease progression prior to CIILC onset, off time (34.9-59.7%) and on time (2.6-48.0%; with or without disabling dyskinesia), Hoehn and Yahr score during on time, Unified Parkinson's Disease Rating Scale-III score during both on and off time, presence of ≥ 4 motor symptoms, and CIILC dose. Significant differences were observed during follow-up (> 24 months in 9 of the 11 CAs studied) for the percentage of off time and on time without disabling dyskinesia, adverse events frequency, and Clinical Global Impression scores. The rate of CIILC discontinuation was between 20-40% in 9 CAs (78 and 80% in remaining 2 CAs).ConclusionsThis study reveals a marked variability between CAs in terms of patient selection and CIILC safety and effectiveness. These results may have been influenced by patients’ baseline characteristics, the availability of multidisciplinary teams, and clinical experience.     

血流导向装置治疗基底动脉巨大动脉瘤的疗效分析

目的 探讨血流导向装置（FD）治疗基底动脉巨大动脉瘤的疗效。方法 回顾性分析2016年7月至2020年7月采用FD治疗的17例基底动脉巨大动脉瘤的临床资料。结果 17例（17个动脉瘤）共置入28枚FD（22枚Pipeline支架,6枚Tubridge支架）,成功释放27枚。术后发生并发症共11例（64.7%,11/17）,其中缺血6例,出血2例,占位效应加重3例。14例临床随访1~60个月,平均（18.1±16.3）个月;预后良好（改良Rankin量表评分0~2分）11例,重残1例,死亡2例。10例影像学随访3~60个月,平均（17.8±18.9）个月;8例动脉瘤完全闭塞,2例残腔稳定;9例载瘤动脉通畅,1例因术中支架脱入动脉瘤瘤腔内而闭塞基底动脉。结论 对于基底动脉巨大动脉瘤,FD治疗的动脉瘤闭塞率较高,效果良好;但是术后并发症不容忽视,临床应注意防治。     

琥珀酸美托洛尔缓释片在高龄合并快速永久性心房颤动治疗中的有效性和安全性分析

目的分析琥珀酸美托洛尔缓释片在高龄合并快速永久性心房颤动治疗中的有效性和安全性。方法选取70岁以上伴有快速永久性心房颤动40例。在基础治疗上加用小剂量酒石酸美托洛尔片逐渐达到靶剂量,2周后按照1∶1更换为琥珀酸美托洛尔缓释片,继续观察2周。分别记录患者症状、清晨静息心率,检查B型尿钠肽、动态心电图及动态血压并进行分析。结果琥珀酸美托洛尔缓释片的治疗靶剂量为（66.25±18.75） mg。患者在琥珀酸美托洛尔缓释片治疗后症状、24 h平均心率、清晨静息心率、24 h平均血压、B型尿钠肽均较用药前明显改善,差异有统计学意义(P<0.05)。琥珀酸美托洛尔缓释片当使用到靶剂量时最长R-R间期无明显延长,患者未出现不适症状。结论在高龄合并快速永久性心房颤动治疗中,琥珀酸美托洛尔缓释片有着良好的临床疗效和安全性,值得临床应用。     

河北省20年改水降氟工作进展及效果分析

目的总结河北省20余年地方性氟中毒病区的改水降氟工作进展,评价改水降氟控制地方性氟中毒的效果.方法对全省2001年地方性氟中毒防治工作年报表、改水井水氟动态监测、省级氟中毒监测点的结果进行统计分析.结果截止到2001年底,累计改水5 604处,总改水率为63.04%.在各类氟中毒病区中,重病区村的改水率最高,达到82.37%;中病区村的改水率次之,为71.04%;轻病区村的改水率最低,为54.76%.平均改水合格率为63.73%,大部分市的改水井水氟合格率较高,有5个市的水氟合格率在83.26%～98.75%,有3个市的水氟合格率在70.90%～79.59%.省级氟中毒监测点病情监测发现,除1个市外,其余各市的监测点8～12岁学生氟斑牙的患病率均达到非病区的标准(＜30%).累计受益人口679.93万,占病区总人口的73.04%.结论河北省的改水降氟工作取得了显著成效.     

Mandatory communication training of all employees with patient contact

In 2010 a communication program that included mandatory communication skills training for all employees with patient contact was developed and launched at a large regional hospital in Denmark.