Comparison of Ultrasound Measurements at the Heel Between Adults With Mental Retardation and Control Subjects

Little is known about the prevalence of metabolic bone disease among adults with mental retardation (now known as learning disability), although they may be at increased risk of fractures. Broadband-ultrasound attenuation (BUA) and velocity-of-sound (VOS) measurements were performed on the left heel of 170 patients in a large hospital for adults with mental retardation. For 108 of these patients, age- and gender-matched control subjects were recruited from the local community, who also underwent BUA and VOS measurements. The mean age of matched pairs of patients and control subjects was 54 (range 32–83) years for men and 53 (range 27–82) years for women. Mean ± SEM BUA for male patients was 52 ± 4 dB/MHz and 89 ± 2 for control subjects, whereas for female patients it was 34 ± 3 dB/MHz and 68 ± 2 for control subjects. VOS was 1603 ± 7 m/sec for male patients and 1649 ± 5 for control subjects, and 1573 ± 7 m/sec for female patients and 1623 ± 5 for control subjects. All differences between patients and control subjects were significant (p < 0.005). Dual-energy X-ray absorptiometry bone mineral density (BMD) measurements were also performed in seven patients with BUA less than 50 dB/MHz, four of whom were found to have a lumbar spine or femoral neck BMD more than 2.5 SD below the mean value for young adults. This study shows that patients with mental retardation have a marked reduction in BUA and VOS measurements at the heel, compared with age-matched control subjects. There is a need to identify the major causes of low bone mass in this group, as there may be potentially avoidable risk factors for osteoporosis, such as vitamin D deficiency and hypogonadism.     

Psychosocial aspects of road traffic trauma--benefits of an early intervention?

PURPOSE: To assess the psychosocial consequences of traffic accidents, and to evaluate the effect of an intervention programme to reduce the occurrence and extent of psychosocial residual states. MATERIAL AND METHODS: A telephone interview was conducted with 314 individuals, 1(1/2)-2 years after the accident in 1994-1995. The effect of the intervention programme was studied for inpatients, 68 in the study group, and 89 in the control group. The structured follow-up form included the Impact of Event Scale (IES). RESULTS: Half of those injured had residual physical complaints with negative effects on their work- and economic-situation. An influence on housing or the need for practical assistance was reported by 1-7%. Mental effects were reported by 4/5. IES demonstrated that 1/5 suffered a high degree of intrusion, and this occurred twice as often among females as among males. Situational anxiety occurred more often in the intervention group than in the control group, p=0.02. More individuals in the intervention group than in the control group were satisfied with the medical certificate to the insurance company, p=0.058. CONCLUSIONS: Females were afflicted by mental effects considerably more than males. The intervention programme did not appear to reduce the psychosocial sequelae. The methods within this area need to be further developed.     

心理健康管理对综合医院体检慢性病筛查与管理的有效性

目的探讨心理健康管理对体检慢性病筛查与管理的有效性。方法随机抽取体检筛查的慢性病231例,排除相关因素,对其中的201例进行体检后心理健康管理,主要采用体检报告与心理测评报告结合方式进行讲解答疑工作,对筛选出的慢性病患者进行心理健康指导与效果评估。结果参与心理健康管理后,83.58%的患者主观感受较好,67.67%自感心理健康水平有所提升,79.10%疾病复发次数降低,90.55%体检结果转好,73.13%经访谈后表示会继续参加心理健康管理。结论心理社会因素在心身疾病的发生、发展、治疗和预后中起重要的作用,心理健康管理对慢性病康复有促进作用。     

光子嫩肤技术联合胶原蛋白敷料贴在皮肤美容中的应用效果

探究将光子嫩肤技术联合胶原蛋白敷料贴应用于皮肤美容的效果。方法 选取2020年5月-2022年8月于我院行皮肤美容治疗的150例患者为研究对象,随机分为对照组和观察组,每组75例。对照组采用光子嫩肤技术治疗,观察组采用光子嫩肤技术联合胶原蛋白敷料贴治疗,比较两组临床疗效、心理状况、复发情况及不良反应发生情况。结果 观察组治疗总有效率为96.00%,高于对照组的60.00%（P＜0.05）;观察组干预后SAS评分、SDS评分均低于对照组（P＜0.05）;观察组复发率为0,低于对照组的6.67%（P ＜0.05）;两组不良反应发生率比较,差异无统计意义（P ＞0.05）。结论 光子嫩肤技术联合胶原蛋白敷料贴在皮肤美容中的应用效果确切,可提升美容效果,有效安抚患者情绪,且治疗后复发率较低,不会增加不良反应发生风险,预后理想。     

‘Lost’: listening to the voices and mental health needs of forced migrants in London

Abstract

Research into the mental health needs of asylum seekers and refugees has revealed that they are likely to experience poorer mental health as well as higher levels of exclusion and vulnerability than native populations. This paper reports on data drawn from semi-structured interviews of 21 refugees and asylum seekers that describe the complexity experienced by those living in exile, and the necessity for a more integrated and holistic approach in the planning and delivery of services to support mental health. Incorporating a perspective from service users will encourage providers to take account of the multitude of practical, social, cultural, economic and legal difficulties that can influence the long-term mental health of this population. The implications highlight a need to shift from a simple biomedical model of the causes and effects of ill-health to a social model, which will require re-organisation not only in healthcare but in welfare, housing, employment and immigration policy.     

武警新入伍战士心理健康状况调查

 目的 探讨新入伍战士的心理健康状况,便于部队科学地开展心理卫生工作.方法 采用 SCL-90 临床症状自评量表对武警战士进行团体施测,并与军队常模、地方常模进行比较.结果 与军队常模相比,武警战士的各项因子分除精神病性和敌对性外均显著高于军队常模(P<0.001);与地方常模相比,战士的各因子分均显著高于地方常模(P<0.001).结论 武警战士的心理健康问题相对突出,需要给予健康的心理疏导.     

西藏高原军人应对方式、状态特质焦虑与心理健康的相关性研究

目的探讨西藏高原军人应对方式、状态特质焦虑与心理健康的关系。方法整群随机抽取西藏高原军人1560名，进行应对方式量表、状态特质焦虑量表、症状自评量表（SCL-90）测试。结果SCL-90与全国常模比较除人际关系因子无显著差异（P〉0．05）外，其余项目因子分显著增高（P〈0．01），除应对方式解决问题、求助因子显著降低（O．13±0．15／0．28±0．22、O．21±0．19／0．46±0．26，P〈0．01）外，其余4个因子显著高于军人常模；状态-特质焦虑分显著低于国内常模；除人际关系外，SCL-90各因子与应对方式中的解决问题、求助因子呈显著负相关（P〈0．01）；而与应对方式中的其余4个因子及状态、特质焦虑总分呈显著正相关（P〈0．01）；对西藏高原军人心理健康的影响大小依次为特质焦虑、自责、解决问题、合理化（B=0．015、0．17、-0．42、0．21）。结论西藏高原军人心理健康受应对方式、状态-特质焦虑的影响。     

Analysis of genes encoding laminin β2 and related proteins in patients with Galloway–Mowat syndrome

Galloway-Mowat syndrome (GMS) is a rare autosomal recessive disorder characterized by early onset nephrotic syndrome and microcephaly with various anomalies of the central nervous system. GMS likely represents a heterogeneous group of disorders with hitherto unknown genetic etiology. The clinical phenotype to some extent overlaps that of Pierson syndrome (PS), which comprises congenital nephrotic syndrome and distinct ocular abnormalities but which may also include neurodevelopmental deficits and microcephaly. PS is caused by mutations of LAMB2, the gene encoding laminin beta2. We hypothesized that GMS might be allelic to PS or be caused by defects in proteins that interact with laminin beta2. In a cohort of 18 patients with GMS or a GMS-like phenotype we therefore analyzed the genes encoding laminin beta2 (LAMB2), laminin alpha5 (LAMA5), alpha3-integrin (ITGA3), beta1-integrin (ITGB1) and alpha-actinin-4 (ACTN4), but we failed to find causative mutations in these genes. We inferred that LAMA5, ITGA3, ITGB1, and ACTN4 are not directly involved in the pathogenesis of GMS. We excluded LAMB2 as a candidate gene for GMS. Further studies are required, including linkage analysis in families with GMS to identify genes underlying this disease.     

Systematic effects of surgical treatment of hip fractures: Gliding screw-plating vs intramedullary nailing

Aim

Numerous studies have been published regarding the comparison between intramedullary nail and the dynamic hip screw and plate for the fixation of intertrochanteric fractures in elderly patients. In this paper we present a comparative study of these two methods regarding their systemic effects on this group of patients.

Materials-methods

This is a randomized trial of 120 consecutive patients with an intertrochanteric fracture treated with either extramedullary fixation (dynamic hip screw and plate; DHS, Synthes-Stratec, Oberdorf, Switzerland) or intramedullary nail (Gamma nail, Stryker Howmedica, Freiburg, Germany and Endovis BA, Citieffe, Bologna, Italy).The parameters that we assessed pre-operatively, in addition to their demographics, included their mental state (MMSE), their nutritional and immune state and their pulmonary function. Intra-operatively we calculated the amount of radiation exposure, the amount of blood loss and the length of operative time for each procedure. Postoperatively we repeated the calculation of the mental and pulmonary state and the blood loss, during days 1, 3, and 10 and related them to the ease of the patient's mobilization.

Results

Decreased bleeding and post-operative pain, reduced post-operative morbidity and faster recovery of function were better but not significant in the group of intramedullary fixation (all p > 0.05). However, in the same group there were slightly more patients in whom the MMSE was falling, together with their pulmonary function, suggesting that this method probably predisposes to higher chances of pulmonary dysfunction and the possibility of pulmonary embolism.

Conclusion

We found no significant differences between the two methods of stabilization of these fractures regarding their systemic effects perioperatively. The classic dynamic hip screw can preserve its position as a safe and effective solution for these already vulnerable patients having sustained a trochanteric fracture against the novel intramedullary techniques.