营养干预对妊娠期和哺乳期妇女骨密度的影响

目的 根据超声定量监测妊娠期及哺乳期妇女骨密度的变化,探讨营养干预的影响.方法 将孕妇分为2组,对120例接受营养干预的孕妇(观察组)分别在孕12周、26周、32周、产后30d、60d、90d进行骨密度检查,同时对120例(对照组)未接受相关营养干预的孕妇进行同时期骨密度检查.结果 ①观察组与对照组间孕12周和孕26周2组间骨密度的比较P＞0.05,而孕32周骨密度的比较P＜0.05;②观察组与对照组产后30d、60d、90d的比较P＜0.05,2组间差异均有显著性.结论 ①骨量减少贯穿于整个孕期,特别是孕晚期及哺乳期;②营养干预能预防孕期及哺乳期的骨量减少,增加乳汁中钙含量,有利于母婴的健康.     

基层医院临床不合理用药浅析

目的 为确保患者用药安全,提高基层医院合理用药水平,对我院不合理用药情况及原因进行分析.方法 随机抽取本院一时段门诊西药处方1480张,根据有关药学理论,统计其不合理用药处方进行分类和统计分析.结果 不合理用药处方合计138张 (占9.32%),不合理用药主要表现在四个方面,分别为联合用药不合理49张、重复用药37张、选药不30张、用法不合理22张.结论 合理用药任重道远,一要临床医生科学用药,二要加强多方面的监督和制约.     

老年病人用药的护理

老年病人由于多脏器病变,在治疗过程中,需要多种药物同时使用,加上其生理特点在用药过程中不同于一般的成人,因此要是老年病人达到安全有效的用药,护理人员必须做好药理护理.     

利用时辰药理学选择最佳用药时间

目的:依据人体的生物节律和药物作用的时辰节律选择最佳用药时间,确定给药方案,正确地指导患者合理用药,提高患者用药依从性.方法:查阅相关文献和书籍归纳、整理,以对正确指导患者合理用药提供帮助.结果:相同的药物、剂量,在一天中的不同时间用药,其疗效和毒性可能相差甚远.体内药物浓度的动态变化和机体的反应往受到机体节律性的影响.结论:把时辰药理学原理应用到临床药物治疗工作中,提高临床用药质量,减少用药量,减少不良反应的发生.     

孕期合理用药

在妇产科门诊经常会遇到一些忧心忡忡的年轻孕妇，她们遇到的问题常常是在自己不知道怀孕的情况下服用了一些药物，不知道这些药物对胎儿有无影响，另有一些人则知道自己已经怀孕了，但又患了其它疾病，为了不影响胎儿，即便病得再严重仍坚持不吃药，实际上这两种情况都进入了妊娠期     

浅谈临床常见的药品不良反应与安全用药问题

在我国,药物不良反应在住院患者中的发生率约为20%,每年由于滥用抗生素引起的耐药菌感染造成的经济损失就达百亿元以上,WHO报告,全球死亡人数中有近1/7的患者是死于不合理用药.合理用药的基本要素是以药物和疾病的知识和理论为基础,有效、安全、经济及适当的使用药物.本文结合笔者的临床工作实践体会对临床常见的药品不良反应与安全用药问题进行了探讨.     

临床不合理用药浅析

通过对中心药房有关资料及参考住院病历，对临床不合理用药进行了分析，供医护人员尤其是药学工作者参考。     

剖宫产瘢痕妊娠(CSP)1例

剖宫产瘢痕妊娠(cesareanscarpregnancy,CSP)是妊娠囊种植在前次剖宫产手术瘢痕部位的子宫肌层,是很罕见的一类异位妊娠.     

慢性胃炎用药规律临床探析

慢性胃炎是多种胃粘膜炎性疾病的总称,俗称胃气痛,系消化道常见病、多发病之一.慢性胃炎属于中医的胃脘痛,反复发作.治疗时应采取综合疗法,如以药物疗法为主,配合情志、饮食、体育、按摩针灸等疗法,或饮食疗法与体育疗法并举等,往往有一定疗效.慢性胃炎的用药,如何选择药物,合理配伍组方,是提高疗效的重要因素.目前对本病尚缺乏特殊疗法,治疗时须合理选择药物,这对于提高治疗效果很重要.     

围手术期间妇产科感染的分析

本文通过对本院妇产科2007年5月至2010年3月收治的216例妇产科手术患者进行了临床研究分析,在对妇产科患者围手术期感染的预防及处理时,一定要遵照本文中预防性使用抗生素时的原则,同时加大对感染病原体研究,力争做到对症下药,提高感染预防及处理的成功率,为广大患者带来福音、为和谐社会出一份力.     

Normal puerperium and breast-feeding

Mothers who have just given birth need support from medical staff and also from their home surroundings. The type of support given to mothers and their new babies varies in different countries and cultures, but should be equally adequate and beneficial. Breast-feeding, as the very best method of early nutrition of the newborn, is the central event of puerperium. Its importance, and other practical approaches during this period are discussed and reviewed.     

Early and late effects of breast-feeding: does breast-feeding really matter?

Breast-feeding protects the newborn against infectious diseases in developing as well as in industrialized countries. Protection is conferred against gastrointestinal and respiratory tract diseases as well as against otitis media. This protection provided by specific (antibody dependent) and broad, nonspecific protective factors in human milk (proteins, glycoproteins, and lipids) is associated with lower global morbidity and mortality of breast-fed infants as compared with formula-fed infants. While protection against diseases that develop later in life, such as insulin-dependent diabetes mellitus, inflammatory bowel disease, and childhood cancer, has been reported, well-planned prospective studies are essential in order to confirm these observations. Similar studies are essential in order to ascertain the small but consistently reported higher cognitive ability of breast-fed infants.     

The treatment of prolactinomas during pregnancy and the lactation period

Thanks to its good long-term results, surgery is the method of choice to treat subcutaneous ruptures of the Achilles tendon. Reconstructed tendons present typical morphological and functional US patterns which depend partly on the kind of surgical reconstruction and partly on the time passed since surgery. The authors report the results of the clinical and US follow-up of a series of 62 surgical patients treated in 7 years for the subcutaneous rupture of the Achilles tendon. The patients were 55 men and 7 women, whose mean age was 36 years (range: 25-65 years). The left-hand side was affected in 38 patients and the right-hand side in 24 patients. All patients were operated on using an end-to-end suture and reinforcement plastic surgery pulling down a gastrocnemius tendon flap. To homogenize the results, all the US exams were performed by the same operator, in the presence of the orthopedic specialist and under the same conditions: both the involved and the contralateral Achilles tendons were studied, longitudinal and transverse scans were performed with the foot in max. plantar and dorsal flexion and, whenever possible, dynamic scans were also performed making the sural triceps contract against resistance. The following parameters were studied clinically: pain (which was absent in 39 patients, occasional in 11, after stress in 9 and on walking in 3 patients), skin scar trophism (which was eutrophic in 53.23% of patients, keloid in 27.42% and hypertrophic in 19.35% of patients), ankle joint excursion (plantar flexion was impaired in 32.3% and dorsal flexion in 36% of patients), walking on tiptoe (in all, 22.6% of patients complained of difficulties walking on tiptoe) and, finally, work activity resumption (which all patients achieved). US depicted the surgical tendons as much bigger than the contralateral ones (3-4 times on the average), which increase in volume lasted throughout the follow-up. In 75% of patients the echo structure of the surgical tendons was inhomogeneous, with scattered hypoechoic and hyperechoic areas. In the extant 25% of patients, nearly all of them followed-up for over 6 years, US depicted a clear-cut hyperechoic area whose size and echo structure were similar to the healthy tendons'. Our results strongly suggest that tenorrhaphy and flap plastic surgery be used to repair subcutaneous ruptures of the Achilles tendon. US proved to be the most reliable and feasible method also in the follow-up. The US images of the patients submitted to surgery more than 6 years earlier revealed fibrillate reorganization patterns and tendon restructuring. These processes involve both ends of the sutured tendon and not the reinforcement flap, which further confirms the exclusively mechanical, and not biological, function of the latter.     

The outcome of pregnancy and labor after a period of sterility

In a retrospective study is examine the effect of a previous state of sterility on the outcome of pregnancy and labor. For two years (1993-1994) there were 203 (2.6%) women who gave birth after 6.7% +/- 3.5 years of sterility. From the study are excluded 9 women (4.4%) with multifetal pregnancies and 13 cases (6.4%) with different diseases, which may adversely affect the pregnancy of the foetus. In the study group of 181 primiparous women the rate of premature labor is 2.2% which is significantly lower than the hospital incidence (11%) for the same period. The cesarean section (CS) rate after period of sterility is unreasonably high--69%. In the subgroup scheduled for vaginal labor CS are performed in 34% of cases. The indications for the elective CS are complex, less justifiable and partially due to non medical reasons. The past period of sterility has not adverse effect on the course of the vaginal labor or the state of the newborn at delivery.     

Obstacles to and motivation for successful breast-feeding

This study determined obstetric physiotherapists' perceptions about major obstacles to and methods of motivation for successful breast-feeding by means of the Friedman non-parametric procedure for the two-way analysis of variance. Three categories of obstacles were identified: maternal obstacles, health professionals and society. Maternal obstacles mentioned most were insufficient motivation (25%) and knowledge (24%), anxiety (14%), fatigue (14%), and employment (14%). Obstacles related to health professionals included lack of support for mothers (20%), inappropriate lactation management (19%), lack of knowledge (15%), negative attitudes (5%), and staff shortages (5%). With regard to society, lack of support (27%) and life-styles (29%) were identified as significant obstacles. The two most significantly important methods of motivation were information and education (53%) and contact with other breast-feeders (27%). It is concluded that breast-feeding education efforts can be improved by identifying obstacles to breast-feeding and methods of motivation and that the Friedman test may be a statistical procedure to consider for determining priorities.     

Relationship adjustment, depression, and anxiety during pregnancy and the postpartum period.

The associations between relationship adjustment and symptoms of depression and anxiety were evaluated in a sample of pregnant married or cohabiting women (N = 113) who were at risk for perinatal depression because of a prior history of major depression. Women completed self-report measures of relationship adjustment, depressive symptoms, and anxiety symptoms monthly during pregnancy and for the first six months following the birth of their child. Multilevel modeling was used to examine concurrent and time-lagged within-subjects effects for relationship adjustment and depressive and anxiety symptoms. Results revealed that (a) relationship adjustment was associated with both depressive symptoms and anxiety symptoms in concurrent analyses; (b) relationship adjustment was predictive of subsequent anxiety symptoms but not subsequent depressive symptoms in lagged analyses; and (c) depressive symptoms were predictive of subsequent relationship adjustment in lagged analyses with symptoms of depression and anxiety examined simultaneously. These results support the continued investigation into the cross-sectional and longitudinal associations between relationship functioning and depressive and anxiety symptoms in women during pregnancy and the postpartum period. (PsycINFO Database Record (c) 2011 APA, all rights reserved)