生物活性材料义眼台

由于病变和外伤等原因，使一些人眼球摘除，留下外现缺陷。医学上使用义眼台植入眼眶，在上面按装义眼以矫治外形。从前使用的义眼台用玻璃球或硅橡胶制作，使用中均有种类不同的缺点，即无生物活性、密度大等。医学界希望有新型医用材料临床应用。采用液态化学方法合成羟基磷灰石，使羟基磷灰石和微晶玻璃混匀，制成生物活性材料。生物材料和粘结剂、造孔剂，辅助剂一同制成生坯，以适当的温度焙烧成多孔结构义眼台。对材料进行了动物实验与临床应用。动物实验表明，材料具有优异的生物相容性和一定的生物活性。临床应用效果良好。本材料是制备义眼台的新材料。本文就材料研究、动物实验、义眼台的生产工艺进行了探讨。     

Premature infants in car seats: effect of sleep state on breathing

SUMMARY  Previous studies have shown that premature infants may be at risk for hypoxemia and bradycardia when placed in standard car seats. However, the relationship of such breathing abnormalities to sleep state have not been studied. The purpose of the present study was to investigate the effect of car seat positioning on respiratory patterns in preterm infants during sleep and to evaluate their relationship to sleep state. Complete polysomnography, including sleep and breathing parameters, was performed on twenty-eight premature infants. Each infant was randomly assigned to the car seat or prone (crib) position for the first recording period. Following the recording of at least two sleep cycles, the position was reversed. The percentage of active and quiet sleep was calculated and breathing parameters were measured. In the car seat, the infants spent significantly more time in active sleep and less time in quiet sleep than in the prone position, of the respiratory parameters, periodic breathing (PB) was significantly higher in the car seat. The presence of at least one abnormal breathing events (bradycardia, desaturation, PB apnoea) was also significantly higher in the car seat. An analysis of variance (ANOVA) of PB revealed significant sleep-state effect (active vs. quiet sleep), but no significant condition or interaction effects, indicating that PB was more frequent in active sleep regardless of the sleeping condition. It is concluded that increased active sleep in the car seat condition, rather than the positioning of the infant in the seat per se, may account for the increase in periodic breathing and possibly other breathing abnormalities reported in car seats.     

Treatment of defaecation problems in children: the role of education, demystification and toilet training

To evaluate the effect of education in children with chronic defaecation problems, a prospective 6-week intervention study was designed. A total of 54 children (5–14 years) underwent an education programme, with demystification of symptoms and advice about diet and toilet training. The present treatment was continued. After 6 weeks, children with persistent problems received biofeedback training with a follow up of 1 year. The intervention programme was successful in 8 children (15%). Biofeedback training was successful in 49% of the remaining group after 1 year. Conclusion A total of 15% of the children with chronic defaecation problems seen at a referral centre could surprisingly be helped by a simple education programme with, demystification and toilet training. Further studies evaluating treatment in children with defaecation problems should account for the primary effect of these measures. Received: 30 July 1996 and in revised form: 30 November 1996 / Accepted: 11 January 1997     

Evaluation of Safe Kids Week 2004: Age 4 to 9? It's Booster Seat Time!

OBJECTIVE: To assess the effectiveness of a national one week media campaign promoting booster seat use. DESIGN: Pre-test, post-test design based on nationally representative random digit dialing telephone survey, with control for exposure to campaign. SETTING: Canada. SUBJECTS: Parents of children aged 4-9 years. INTERVENTIONS: During a one week campaign in May 2004, information on booster seat use was distributed via a national media campaign, retail stores, medical clinics, and community events. Information included pamphlets with guidelines for booster seat use, as well as a growth chart (designed by Safe Kids Canada) to assist parents in determining if their child should be using a booster seat. Assessing seat belt fit was described in detail on the growth chart. MAIN OUTCOME MEASURES: Knowledge, attitudes, and self-reported behaviors regarding booster seat use. RESULTS: Respondents in the group exposed to the campaign were twice as likely to report using a booster seat with lap and shoulder belt for their child (47%), compared to those in the pre-test (24%) and the unexposed (23%) groups (p<0.001). However, only small differences in general knowledge regarding booster seat use were found between the groups. CONCLUSIONS: A one week national media campaign substantially increased self-reported use of booster seats. Parents did not remember details of the campaign content, but did remember implications for their own child.     

Risk Factors for Injury in Rural Iowa

SUMMARY

Preliminary analyses of data from one third of the Keokuk County Rural Health Study cohort suggest that risk factors for injury among rural populations are not uniformly distributed and that the pattern varies with the risk factor. For some, such as expo-sure to all-terrain vehicles, the occupation of farmer determines the degree of exposure to the risk factor. Similarly, farmers seem less likely than other rural people to wear their seat belts. Although farm-ers are not more likely than rural nonfarmers to have firearms in their homes, they are more likely to have used them in the last year. How-ever, for other injury risk factors such as alcohol consumption, there do not appear to be differences among farmers, rural nonfarmers, and townspeople. These early results suggest that the Keokuk County Rural Health Study will yield important information for tar-geting specific rural injury prevention interventions.     

Validity and reliability of wheelchair sitting posture measures using Coach’s Eye in abled subjects

People in wheelchairs spend a long time in the sitting position and often incur alignment problems resulting in neck and back pain. This study: (1) assessed the validity/reliability of Coach’s Eye (CE) smart device application, (2) examined the effect of seat to back support angle adjustments on head, neck, and shoulder posture in the sitting position, and (3) compared changes in cervical rotation at each back support angle. Abled subjects sat in a wheelchair with back support angles positioned at 90°, 100°, and 110°. CE, as well as ImageJ software, was used to analyze three angles: sagittal head angle (SHA), cervical angle (CVA), and shoulder angle (SA). There were highly significant differences for CVA and SA (p < 0.001) among the three seat to back support angles. Validity of CE was examined by correlating CE with ImageJ scores. CE had high validity for all angles (r = 0.99, 0.98, 0.99 respectively, p < 0.001). Inter-rater reliability for SHA, CVA, and SA was high (intraclass correlation coefficient [ICC] ranged from 0.95 to 0.99). Head (CVA) and shoulder (SA) alignment was closest to neutral posture with back support angles set at 110° and 90°, respectively.     

Critical congenital heart disease screening does not predict car seat tolerance screen outcomes

BackgroundCar Seat Tolerance Screening (CSTS) and Critical Congenital Heart Disease (CCHD) screens were both implemented to identify infants with cardiorespiratory distress. We hypothesized that the CCHD screen would be poorly sensitive to predict a failed CSTS for many reasons.MethodsRetrospective record review of infants in 2013 who qualified for CSTS. Calculated sensitivity, specificity, predictive value (PV) of a failed CCHD screen to identify those infants who failed their CSTS.Results270 subjects underwent both screens and 14 failed a CSTS (5.2%). Of these, 1 failed the CCHD and 1 had an equivocal result. None were diagnosed with CCHD. An abnormal CCHD (failed or equivocal) had a sensitivity = 14.3% and a PV = 40% for predicting CSTS failure.ConclusionsCCHD screening is poorly sensitive and has poor PV for identifying those infants who are at risk of failing a CSTS. We therefore cannot recommend replacement of the CSTS with routine CCHD screening.     

Does training sitting balance on a platform tilted 10° to the weak side improve trunk control in the acute phase after stroke? A randomized,controlled trial

Background: Trunk performance and sitting balance, especially lateral sitting control, are important predictors of functional outcome after stroke. However, no studies have focused only on trunk function in the frontal plane for persons with acute-phase stroke.

Objective: To investigate the effects of lateral sitting training on a tilting platform in persons with stroke.

Methods: An assessor-blinded, randomized, controlled trial was carried out involving inpatients at a stroke rehabilitation center. Patients were allocated to either an experimental group (n?=?15) or a control group (n?=?15). The experimental group sat without leg support on a platform tilted 10° to the paretic side in the frontal plane, while the controls sat on a horizontal platform. Both groups were asked to move their trunk laterally from the paretic side to the nonparetic side. In addition to conventional therapy, this training was performed 60 times/session, with 6 sessions/week. Trunk function was assessed using the Trunk Control Test (TCT), and the ability to move the trunk laterally was evaluated kinematically. Measurements were performed at baseline and after training. Two-way repeated measures analysis of variance was used to test the significance between and within treatments for each dependent variable.

Results: None of the demographic data differed between the groups. After training, a significant improvement was noted in the experimental group compared to the controls in the TCT and the ability for lateral trunk transference (P?<?0.05, 1???β?=?0.98, effect size?=?0.4).

Conclusion: Lateral sitting training on the tilting platform improved the impaired trunk function of persons with stroke.