ABSTRACT
El programa de Diagnóstico y Tratamiento Fetal (PDTF) coordina y optimiza el cuidado prenatal y perinatal de pacientes que consultan por alguna anomalía congénita severa (ACS). El servicio de Salud Mental forma parte del equipo interdisciplinario. Objetivo:Evaluar mediante indicadores específicos (estrés en torno a la internación neonatal, depresión, ansiedad, afrontamiento y apoyo social percibido) el impacto psicológico del PDTF en madres de recién nacidos (RN) con ACS internados en Neonatología, comparándolas con un grupo de pacientes con las mismas ACS ingresados por derivación posnatal habitual (DP). Diseño: transversal, comparativo. Población: madres de niños y niñas con ACS internados en neonatología, que cumplan con los criterios de admisión, con consentimiento. Instrumentos de medición: Cuestionario de MOS de Apoyo Social Percibido, Inventario de Depresión de Beck (BDI), Inventario de ansiedad estado/rasgo (STAI), Escala de estrés parental: Unidad de cuidados intensivos (PSS: NICU), Inventario de respuestas de afrontamiento de MOOS (CRI-A). Los datos se analizaron con REDCap y stata 12.0. Resultados: muestra constituida por 83 madres. El 61% tuvo seguimiento en PDTF. No se encontraron diferencias significativas en la edad (M:24a), nivel educativo(55% estudios secundarios o superiores), situación de pobreza (25%), situación conyugal(89% en pareja estable), presencia de red de apoyo(95%). En cuanto a su procedencia el 62% de las madres del PDTF y el 81% de DP provenían de CABA y el Conurbano. Tenían diagnóstico prenatal solo el 31% de las DP. Los diagnósticos más prevalentes de los niños del PDTF fueron gastroquisis (37%) y hernia diafragmática (30%), en los niños con DP cardiopatía (22%) y gastroquisis (19%). Las madres del PDTF presentaron menores niveles de depresión que las de DP. Estas últimas fueron quienes aumentaron en mayor medida su estado de ansiedad con respecto a su rasgo habitual. El apoyo social percibido fue alto en ambos grupos al igual que el afrontamiento por aproximación. Conclusiones: Las intervenciones del programa tuvieron un efecto positivo sobre la ansiedad y la depresión en las madres durante la internación neonatal. (AU)
The Fetal Diagnosis and Treatment Program ( FDTP) coordinates and optimizes prenatal and perinatal care of patients who consult for severe congenital anomalies (SCA). The Mental Health Department is part of the interdisciplinary team. Objective: To evaluate by means of specific indicators (stress around Neonatal Intensive Care Unit (NICU) admission, depression, anxiety, coping, and perceived social support) the psychological impact of the FDTP on mothers of newborns (NB) with SCA admitted to the NICU compared to a group of patients with the same SCA admitted through regular postnatal referral (PR). Design: cross-sectional, comparative study. Population: mothers of children with SCA admitted to the NICU who met the admission criteria and who signed informed consent. Measurement instruments: MOS Social Support Survey, Beck Depression Inventory (BDI), StateTrait Anxiety Inventory (STAI), Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU), Moos Coping Responses Inventory (CRI-A). Data were analyzed using REDCap and Stata 12.0. Results: the sample consisted of 83 mothers. Sixty-one percent were followed up by the FDTP. No significant differences were found in age (M:24y), educational level (55% secondary or higher education), poverty status (25%), marital status (89% in stable relationship), or presence of support network (95%). Regarding their origin, 62% of the FDTP mothers and 81% of the PR mothers came from the city of Buenos Aires and Greater Buenos Aires. Only 31% of the PR children had a prenatal diagnosis. The most prevalent diagnoses in the FDTP children were gastroschisis (37%) and diaphragmatic hernia (30%), and in the PR children, cardiopathy (22%) and gastroschisis (19%). FDTP mothers presented with lower levels of depression than PR mothers. The latter were those who increased their state of anxiety to a greater extent compared to their usual trait. Perceived social support was high in both groups, as was coping by proxy. Conclusions: Program interventions had a positive effect on anxiety and depression in mothers during NICU admission (AU)
Subject(s)
Humans , Pregnancy , Infant, Newborn , Prenatal Diagnosis/psychology , Congenital Abnormalities/diagnosis , Congenital Abnormalities/psychology , Adaptation, Psychological , Intensive Care Units, Neonatal , Mothers/psychology , Anxiety/psychology , Stress, Psychological/psychology , Cross-Sectional Studies , Surveys and Questionnaires , Depression/psychologyABSTRACT
@#An outbreak of new infectious disease caused by novel coronavirus （COVID- 19）started in China last year，which mainly leads to pulmonary injuries. The medical workers of the First Affiliated Hospital of Sun Yat-sen University quickly responded to the calls and three medical teams had been dispatched to epidemic area to join the fight against the novel coronavirus. The team creatively established the advanced life support units in general wards in order to rescue the critically ill patients. Hundreds of severe cases had been diagnosed and treated by our medical teams. To standardize the diagnosis and treatment of this new infectious disease ，especially the severe cases，guidelines for the diagnosis and management of COVID-19 is compiled by the First Affiliated Hospital of Sun Yat-sen University.
ABSTRACT
Progressive muscular dystrophy (PMD) mainly includes Duchenne and Becker muscular dystrophy (DMD/BMD),which are common muscular dystrophy diseases in childhood.DMD is the most common disease with poor prognosis.In order to prolong patient's life span,it is necessary to effectively manage their physical condition and complications.So far,there is no cure for muscular dystrophy,but early diagnosis,systematic treatment,combined with rehabilitation training,.more comprehensive and targeted evaluation measures can effectively improve the patient's body dysfunction and prolong the natural course of disease.The purpose of this review is to summarize and introduce the latest diagnostic,therapeutic schemes,evaluation methods of DMD,so as to provide more systematic therapeutic ideas and detailed evaluation schemes for medical workers.
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Objective:To comprehensively analyze the diagnosis and treatment programs and prevention and treatment programs on tratidional Chinese medicine (TCM) for coronavirus disease-2019 (COVID-19), and to provide suggestions for further development of TCM clinical guidelines. Method:Diagnosis and treatment programs on TCM for COVID-19 pneumonia, as well as prevention and treatment programs, clinical practice guidelines and expert consensus, were retrieved till Feb 19, 2020. The information about TCM syndrome differentiation, state of disease, and TCM treatments (decoction and Chinese patent medicines) were extracted and analyzed. Result:A total of 24 TCM programs/guidelines were included containing 23 diagnosis and treatment programs or prevention and treatment programs and one rapid advice guideline. Of the 23 TCM programs, 14 programs described the classification of TCM syndromes and the stages of disease，22 programs described the composition of the TCM decoction; seven programs described how to add and subtract the herbs according to different TCM syndromes,17 programs described the weight/volume of the herbs of TCM decoctions, three programs described the decoction method，six programs described the usage and dosage of TCM decoction， two programs clarified the course of treatment; none of the 23 programs indicated the source of evidence. The TCM treatment within the rapid advice guideline was in reference to the fourth edition of the COVID-19 pneumonia TCM diagnosis and treatment program issued by the National Health Commission. A total of 41 Chinese patent medicines were recommended in 23 programs, of which 12 Chinese patent medicines were off-label recommended. Conclusion:In most TCM programs, TCM decoction and Chinese patent medicines are recommended based on TCM syndrome differentiation in combination with the state of disease, and the dosage of the TCM decoctions are clearly described. Some Chinese patent medicines in the TCM programs are off-label recommended. Expert experience and opinions are valued when developing TCM programs/ guidelines. All of these provide reference for developing TCM programs/guidelines in future.
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To investigate the establishment and evaluation of TCM diagnosis and treatment protocols of post infectious cough based on its status and problems. It will make the TCM syndrome standardization easy to popularize,and realize the optimization and simplification of TCM treatment protocols,establishment of western medicine diagnostic criteria beseem different hospital,and selection of scientific and accepted outcome measurements,to improve level of TCM diagnosis and treatment of post infectious cough and quality of its clinical research.
ABSTRACT
Dyslipidemia is one of metabolic disorder of blood lipids including cholesterol or triglycerides.Based on the close relationship with the atherosclerosis,there is little doubt that hyperlipidemia is the major risk factor for morbidity and mortality of cardiovascular diseases.To control dyslipidemia is one of the most important measures to prevent and cure the cardiovascular diseases.The patients with dyslipidemia will take life-term western medicine.However Chinese medicine does well in treating light and middle grade dyslipidemia,which can reduce development of cardiovascular incidents and adverse reactions of western medicine.This guideline assembled all the experts'experience and expertise from Cardiopathia Committee of China Association of Chinese Medicine,which was also based on nearly thirty-year literature searching about essential hypertension home and abroad.Furthermore,we mainly classif ied TCM syndromes and made treatment principles according to our achievement in the last decade and six expert consensus conferences.This article will introduce such a guideline that we want to gather different opinions and suggestions all over our country in order to improve curative effect in practice.Besides,some information about nursing,prevention and rehabilitation is also discussed for the sake of preventing and reducing essential dyslipidemia and its complications,which is according to the theory of"Preventive Treatment of Disease"of Nei Jing.