Archive for October, 2008

Forget ECG service antipsychotics

Thursday, October 30th, 2008

Forget ECG service antipsychotics

In clinical work, we often encounter long-term use of antipsychotic drugs in patients and family members ignore the return visit to the hospital regularly, advising them on a regular basis ECG, often without was prescribed a variety of reasons, resulting in serious adverse reactions, sometimes even life-threatening.

As we all know that drugs are some serious side effects, such as cardiac side effects. Whether traditional or novel antipsychotics, can lead to heart adverse reactions, ECG has been caused to predict cardiac side effects of antipsychotic drugs, an effective tool to prevent sudden death.

Antipsychotic-induced ECG abnormalities, including bradycardia, tachycardia, ECG changes, conduction block and so on. Current antipsychotic-induced QTc interval prolongation more concerned about.
QT interval refers to ventricular repolarization from the extreme end than the beginning of time, QTc interval is adjusted by the formula of QT interval. QT interval of the normal range of 320 ~ 440 ms, QTc interval prolongation may lead to syncope, ventricular fibrillation cardiac arrest and sudden death, great harm to life.

Many antipsychotic drugs can cause
QTc interval prolongation, such as chlorpromazine, clozapine, haloperidol and so on. It is reported that clozapine induced QTc interval prolongation 71.43% incidence rate, the elderly and associated with cardiovascular and cerebrovascular diseases, mental illnesses are at high risk of sudden death, the mentally ill, even taking moderate doses of antipsychotics, sudden death risk is also relatively large.

Therefore, the long-term use in patients with antipsychotics should regularly return visit to the hospital to conduct ECG monitoring, prevention of antipsychotic-induced adverse cardiac events. The current proposal is: 1. A comprehensive assessment of the baseline ECG results. 2. The treatment of periodic ECG and electrolytes. In case of tachycardia, dizziness, syncope, or epilepsy, should be immediately electrocardiogram. 3. If the ECG report tips
QT interval more than 500 milliseconds, it is recommended to immediately stop the anti-psychotic drugs.
Chen Yanlin

Ligament injury

Monday, October 13th, 2008

Ban massage knee ligament stability mainly depend. There were four knee ligaments medial collateral ligament, lateral collateral ligament, and after two cruciate ligament. If there is a ligament injury, and will result in joint instability, articular cartilage appears friction, strain, damage, resulting in inflammation, knee pain occurs.
Check X ray or MRI do not necessarily
Some patients think that just fell about, no need to go to the hospital, and went to the hospital is necessary to shoot X-rays, MRI and other tests done, more money is not that there is radiation. Chinese medicine hospital in Shenyang City, director of orthopedic ward Liu Yandong warned that if the climbing process, the movement, usually on the down, on and off such circumstances knee injuries, sprains Ye Hao, contusion Ye Hao, fall or that they are knee a fall in the action, and the local symptoms of pain, better go to hospital to see to what extent ligament injury, whether the fracture. Liuzhu Ren explained that the hospital is not necessarily to do X ray, magnetic resonance and other checks. First of all, patients with a doctor will do a lateral pressure test to determine joint ligament is part of the injury or disruption. If the patient severe pain, could not bear inspection, it needs to do X ray, ultrasonography or MRI, to check whether the joint structure and associated with fractures.
Bed rest after injury is the key
After medical examination if there is ligament tear, they must stay in bed, preferably about 30 degrees of knee flexion bed rest, the position of the knee joint ligament relaxation place, conducive to recovery. Liu Zhuren stressed ligament injury if within 3 weeks to get timely treatment can restore the general good, there is no effect on the future, if within 3 weeks if not careful, a little fighting back pain and gait, then the already damaged The ligament in the process of walking the force of stimulation, the possibility of more severe injury. After 3 weeks, ligament relaxation, it is difficult to restore the toughness of the former. This case, it is easy to cause joint instability, during intense exercise, when the imbalance of power, it is easy to damage.
Acute phase of the absolute prohibition of massage and physical therapy
Some patients with knee pain or when their hot-water bottle hot massage to relieve pain. Liu Zhuren that ligament injury, the acute phase can use a number of local blood circulation in plaster, two weeks can be a number of blood circulation and strengthening sinews and bones type of traditional Chinese medicine, on the swelling and relieve pain to a certain extent. But the ligament damage is absolutely prohibited massage and physical therapy, such as hot, grilled electricity. Because the ligament has been injured, and massage will increase the extent of ligament damage, the more press the more serious. Soft tissue and ligament injury will also be leakage or bleeding, do physical therapy will increase the leakage and bleeding, can only be counterproductive. Remission of swelling, pain, swelling of the local symptoms have disappeared, then no need to continue taking oral medication, and this time if there is residual pain, you can do some physiotherapy.
Activities of anti-wear knee ligament injury
"11" holidays, many people choose to travel. Liu Zhuren to remind readers, especially those who usually lack of exercise, in mountain climbing, playing basketball, soccer and other strenuous exercise, the best to wear some protective equipment, such as wearing a knee in the knee, ankle wearing a ankle, bound look, can reduce the stress ligaments, stress on the strength of some dispersion. Again, the exercise should have protection consciousness, too, too dangerous or do not take action to do as much as possible. Also, if not usually exercise, muscles can not adapt to sudden powerful movement can easily lead to Achilles tendon, knee injury, fatigue and so on. Therefore, the best do some warm-up before vigorous exercise, so that the joints, ligaments as the open and reduce the risk of injury.
Rotating intern reporter Li Ma Yunwen

6 weeks postpartum depression prevention

Tuesday, October 7th, 2008

She had got just a mother, before her cheerful mood suddenly quiet, emotional instability, there was even a depression, insomnia and other symptoms. Later, accompanied by his family after she had got to the hospital would only be aware of suffering from postpartum depression, a comprehensive conditioning.

6 weeks postpartum mothers prone to depression and the new time, which during this period the level of female hormones, combined with post-suited to the new role, breast feeding is difficult, and some physical discomfort will make the new mother by the excitement of a child born to disappointment when, psychological burden, severe cases will show symptoms of depression. So, for less than 6 weeks postpartum new mothers not only concerned about her physical condition, must also be concerned about her psychological state.

1. To create a good environment for the new mother, that is to live comfortably, eat reasonably, and surrounded by the company of people, such as mother, mother, grandmother, etc., to help guide new mothers feeding their children, especially her husband to show more concern, caring and love so that the new mother in a warm and comfortable environment to survive this period.

2. To encourage new mothers in the absence of perinatal complications as much as many do, Ruan point home, went for a walk, the sun, chat with people to help ease the mood, maintaining a happy and activities promote physical rehabilitation.

3. New mothers should pay attention to start to learn something about pregnancy development and neonatal care, breastfeeding and perinatal health care knowledge in order to be prepared psychologically, to avoid the psychological burden caused by unprepared. In addition, the new mother to ensure adequate sleep, less leisure time watching television, listening to music or turn a blind eye repose, in order to maintain abundant energy, you can prevent depression because of the shortage of energy.

Han Yongxia