舒适护理在经皮冠状动脉介入治疗患者中的应用

目的 探讨舒适护理在经皮冠状动脉介入治疗患者中的护理效果.方法 80例患者随机分为观察组和对照组各40例,对照组采用常规护理,观察组采用舒适护理模式,比较2组患者心理、生理舒适度,以及对护理质量和满意度的评价.结果 观察组患者心理、生理舒适度评分显著低于对照组;观察组患者对护理质量和满意度评价均显著优于对照组.结论 经皮冠状动脉介入治疗的患者实施舒适护理,可以提高患者的心理、生理舒适度,以及护理质量和满意度,值得临床推广应用.     

舒适护理在急性心肌梗死急诊介入中的应用

目的:探讨舒适护理在急性心肌梗死患者行急诊介入治疗中的应用效果。方法:将128例急性心肌梗死行急诊介入治疗患者随机分成实验组与对照组各64例,对照组实施常规护理,实验组在常规护理的基础上实施舒适护理,观察、比较两组术后不良反应发生情况及患者满意度。结果:实验组不良反应发生率低于对照组,患者满意度高于对照组,两组比较差异均有统计学意义(P<0.05)。结论:舒适护理应用在冠状动脉介入围术期中能显著提高介入患者在生理和心理上的舒适度,对提高急性心肌梗死急诊介入患者的生活质量具有重要意义。     

急性心肌梗死介入治疗15例舒适护理

目的:探讨对急性心肌梗死行冠状动脉介入治疗后的患者实施舒适护理的效果。方法:将30例患者随机分为观察组与对照组各15例,对照组行常规护理,观察组在常规护理基础上实施舒适护理。结果:观察组护理后不适反应发生率明显低于对照组,对护理的满意度明显高于对照组(P<0.05)。结论:急性心肌梗死行冠状动脉介入治疗后实施舒适护理可减少患者的不适反应,提高其对护理的满意度。     

临床护理路径在抢救急性心肌梗死患者中的应用

目的 探讨临床护理路径(CNP)在抢救急性心肌梗死(AMI)患者中的应用效果.方法 将90例急性心肌梗死患者随机分为观察组及对照组各45例,对照组采用传统的医疗护理方法,观察组采用急救护理路径.比较2组患者健康知识掌握情况、满意度、术后并发症、住院时间、医疗费用等各项指标,进行χ2检验和t检验.结果 观察组的健康知识掌握情况和患者满意度情况明显高于对照组;术后并发症、院内心肌梗死再次发作、再次行经皮冠状动脉介入治疗(PCI)、死亡情况比较,观察组例数明显少于对照组;住院时间比较,观察组明显短于对照组;医疗费用比较,观察组明显少于对照组.结论 在AMI患者的抢救中应用CNP,为整体护理改革及护理质量管理提供了一种有效的方法和途径,值得推广应用.     

行经皮冠状动脉介入术的急性心肌梗死患者的围术期护理

目的探讨分析行经皮冠状动脉介入术的急性心肌梗死患者的围术期护理效果。方法选择本院2016年1月~2017年6月收治的58例急性心肌梗死经皮冠状动脉介入术治疗患者作为研究对象,采用随机分组的方式将其分成对照组与观察组,每组各29例。对照组患者给予常规护理干预,观察组患者给予围手术期的护理,分析两组患者的护理效果、住院时间、医疗费用和患者家属的护理满意度。结果对照组患者临床治疗的总有效率为70.0%,观察组有效率为92.0%;对照组患者家属的护理满意度为64.0%,观察组为82.0%;观察组比对照组的患者住院时间平均缩短了(4~5)d左右,医疗费用降低了10%左右,两组差异均具有统计学意义(P0.05)。结论对急性心肌梗死经皮冠状动脉介入术治疗患者实施围手术期护理的效果较好,能缩短患者住院时间,降低医疗费用,有效缓解患者临床症状,提高临床疗效,且患者家属的护理满意度较高。     

经皮冠状动脉介入治疗急性心肌梗死的临床护理观察

目的探讨综合护理干预在经皮冠状动脉介入治疗急性心肌梗死的临床应用效果。方法选取2012年1月至2013年1月哈尔滨医科大学附属第四医院收治的经皮冠状动脉介入治疗的急性心肌梗死患者110例,按随机分组原则分为观察组和对照组,对照组实施常规护理措施,观察组实施综合护理干预。比较2组患者术后并发症的发生率、平均住院时间、患者对护理服务的满意度并进行评价。结果观察组患者并发症的发生率和平均住院时间明显低于对照组,对护理服务的满意度明显高于对照组,差异有统计学意义(P0.05)。结论对经皮冠状动脉介入治疗的心肌梗死患者实施综合护理干预,可有效预防并发症发生,提高患者满意度,建议在临床上推广应用。     

临床护理路径在急性心肌梗死患者行急诊经皮冠状动脉介入治疗中的应用

目的探讨临床护理路径在急性心肌梗死患者行急诊经皮冠状动脉介入治疗中的应用效果。方法将我院急诊科实施临床护理路径前后收治的93例急性ST段抬高心肌梗死患者按是否实施护理路径分组,对照组患者入院后按照急性心肌梗死常规抢救程序进行护理;观察组患者人院后按照临床护理路径的标准模式实施护理,比较两组患者由急诊科接诊至送入导管室时间的差异。结果观察组患者急诊接诊至送入导管室时间比对照组明显缩短,差异有统计学意义（P〈0．01）,观察组对护理工作满意度高于对照组（P〈0．01）。结论l晦床护理路径在急性心肌梗死患者急诊经皮冠状动脉介入治疗中的应用,可规范急诊护理行为,提高工作效率,为患者赢得更多的救治时间,提高患者满意度。     

临床护理路径在抢救急性心肌梗死患者中的应用

目的探讨临床护理路径（CNP）在抢救急性心肌梗死（AMI）患者中的应用效果。方法将90例急性心肌梗死患者随机分为观察组及对照组各45例,对照组采用传统的医疗护理方法,观察组采用急救护理路径。比较2组患者健康知识掌握情况、满意度、术后并发症、住院时间、医疗费用等各项指标,进行r检验和t检验。结果观察组的健康知识掌握情况和患者满意度情况明显高于对照组;术后并发症、院内心肌梗死再次发作、再次行经皮冠状动脉介入治疗（PCI）、死亡情况比较,观察组例数明显少于对照组;住院时间比较,观察组明显短于对照组;医疗费用比较,观察组明显少于对照组。结论在AMI患者的抢救中应用CNP,为整体护理改革及护理质量管理提供了一种有效的方法和途径,值得推广应用。     

多学科协作护理救治急性心肌梗死患者

目的：探讨多学科协作护理模式下救治急性心肌梗死患者的临床效果。方法：将300例急性心肌梗死急诊行经皮冠状动脉介入治疗忠者分为对照组和观察组各150例。对照组采用传统护理模式,观察组采用多学科协作护理模式,比较两组就诊至球囊扩张时州、平均住院时间及对护理服务满意度、对疾病知识知晓率。结果：观察组患者就诊至球囊扩张时间、平均住院时间低于对照组,忠者对护理服务满意度及对坎病知晓率高于对照组。结论：多学科协作护理模式是一种新的护理模式,在救治急性心肌梗死忠者中具有高效性、实用性,值得推广。     

急性心肌梗死介入治疗后的早期康复护理

目的 探讨延迟经皮冠状动脉介入治疗(PCI)急性前壁心肌梗死(AMI)后的早期康复护理效果.方法 选择146例急性前壁、前间壁及广泛前壁Q波性AMI支架置入术后患者,术后分为两组进行护理,对照组73例,进行常规护理,观察组73例,在常规护理的基础上增加早期康复护理,比较两组的护理效果,以两组患者的住院时间、出入院时的肌酸激酶(CK)比值、肌钙蛋白比值、射血分数比值为主要效果评价.结果 观察组的住院时间显著少于对照组(P<0.05);且观察组的出入院时CK比值、肌钙蛋白比值、射血分数比值显著优于对照组(P<0.05).结论 急性心肌梗死介入治疗以后早期的康复护理至关重要,可显著改善患者的疗效.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."