Síndrome de Morning Glory / Morning Glory Syndrome

Introducción: la anomalía congénita del disco óptico conocida como "morning glory" (MG) es un desarrollo anómalo del nervio óptico, caracterizado por una cavidad amplia en forma de embudo del disco en el punto donde salen las fibras del nervio de la retina. Su presentación más frecuente es unilateral. La mayoría de los casos son aislados y no se asocian con anomalías sistémicas. Objetivo: se presenta el caso de un niño de 1 año con MG y los hallazgos imagenológicos. Caso clínico: presentamos el caso de un paciente masculino de 1 año con sospecha de patología visual; en el estudio se realizó resonancia magnética cerebral (RM) en la que se identificó excavación en forma de embudo de la papila del globo ocular izquierdo, alteración en la morfología del quiasma óptico con desplazamiento inferior asimétrico y engrosamiento del infundíbulo y del tallo hipofisiario. Discusión: el diagnóstico de MG es clínico, las imágenes aportan información adicional sobre anomalías oculares, craneofaciales y vasculares asociadas. En este caso además de la lesión ocular había anomalías de estructuras de línea media como el infundíbulo y el tallo hipofisiario, además de engrosamiento quiasmático. Conclusión: la valoración por imágenes en fundamental, no solo para describir la alteración del nervio óptico, si no para identificar y describir anomalías asociadas para realizar manejo integral del paciente.

Introduction: the congenital optic disc anomaly known as morning glory disc anomaly (MGDA) is an alteration of normal optic nerve development, characterized by an enlarged funnel-shaped cavity of the optic disc, the point in the eye where the optic nerve fibers leave the retina. The anomaly is typically unilateral. Most are isolated cases with no associated systemic anomalies. Objective: a case is presented in a one-year-old boy with MGDA and the corresponding imaging findings. Case reports: we present the case of a one-year-old male patient with suspected visual impairment. Cerebral magnetic resonance imaging (MRI) revealed a papillary funnel-shaped excavation in the left eye, alteration in the morphology and inferior asymmetric displacement of the optic chiasm and thickening of the pituitary infundibular stalk. Discussion: MGDA is diagnosed clinically, however, imaging provides additional information regarding the associated ocular, craniofacial and vascular abnormalities. In this case, in addition to the ocular lesion there were abnormalities of midline structures, such as, the pituitary infundibular stalk, as well as, optic chiasm thickening. Conclusion: imaging is fundamental, not only to describe the anatomic alteration of the optic nerve, but also to identify related abnormalities in order to provide patients a comprehensive management

Pílula do Dia Seguinte: Elaboração e Evidências Psicométricas de uma Medida / Morning-After Pill: Psychometric Preparation and Evidence of a Measure

RESUMO Objetivou-se elaborar a Escala de Atitudes Femininas frente à Pílula do dia Seguinte (EAFPDS), reunindo evidências preliminares de validade e precisão. Participaram 223 universitárias (Midade = 21,44; DP = 4,1; amplitude 18 a 46 anos), que foram divididas em dois grupos: sexualmente ativas (51,6%) e não ativas (48,4%). Os resultados mostraram que os itens da medida possuem estrutura bifatorial, o fator I sendo nomeado como Segurança e o fator II como Ansiedade. Os respectivos fatores apresentaram Alfas de Cronbach de 0,62 e 0,67, além de homogeneidade de 0,29 e 0,41. Concluiu-se que este instrumento apresenta evidências preliminares de validade fatorial e confiabilidade, disponibilizando uma medida no português brasileiro que permite medir adequadamente as atitudes femininas frente à pílula do dia seguinte.

ABSTRACT This research aimed to elaborate the Female Attitudes Toward the Morning-After Pill Scale (FAMPS), gathering preliminary evidence of validity and accuracy. There were 223 university women (Mean age = 21.44; SD = 4.1; range 18 to 46 years), who were divided into two groups: sexually active (51.6%) and non-active (48.4%). The results showed that the items of the measure have two-factor structure, factor I being named Safety and factor II as Anxiety. The respective factors presented Cronbach's Alphas of 0.62 and 0.67, in addition to homogeneity of 0.29 and 0.41. It is concluded that this instrument presents preliminary evidences of factorial validity and reliability, providing a measure in Brazilian Portuguese that allows to adequately measure the female attitudes toward the morning-after pill.

Cefalea por abuso de medicamentos y sus marcadores clínicos / Medication overuse headache and its specific clinical markers

Resumen Introducción: Los marcadores clínicos de la cefalea por uso excesivo de medicación (CMA) se basan en la clasificación de las cefaleas desarrollada por la Sociedad Internacional de Cefaleas (IHS). Esta clasificación incluye sólo dos criterios: la frecuencia de los días de cefalea debe ser de 15 o más días al mes durante al menos tres o más meses; - y el número de días de uso excesivo de la medicación debe ser de 10 o 15 días al mes dependiendo del tipo de medicación. Sin embargo, los pacientes suelen tener otros marcadores clínicos asociados distintos, que la mayoría de los médicos pasan por alto durante la evaluación inicial. Metodología: Este estudio es un estudio prospectivo, longitudinal y observacional de 76 pacientes ingresados en la Unidad de Cefaleas del hospital DIPRECA. Todos ellos fueron diagnosticados de HMO según los criterios establecidos por su ICHD III beta.(1) Los pacientes recibieron un tratamiento estándar que incluía desintoxicación y medicación preventiva y fueron seguidos durante 6 meses. Se registraron los síntomas de interés en cada visita de seguimiento clínico y se administraron escalas de evaluación como Zung, MIDAS, HIT-6. Resultados: Los medicamentos sobreutilizados incluyeron antiinflamatorios no esteroideos (AINE), triptanes y cornezuelos. Los síntomas clínicos más significativos asociados fueron: despertar por la mañana con dolor de cabeza, despertar al paciente al amanecer por dolor de cabeza, dificultades de atención, depresión, dolor cervical y síndrome de dolor miofascial. Todos los síntomas mejoraron significativamente al iniciar el tratamiento, al igual que la calidad de vida medida por las escalas MIDAS y HIT-6. Discusión: Al evaluar a los pacientes con HMO, hay que tener en cuenta tanto los criterios diagnósticos de la ICHD III beta como los síntomas comunes y específicos que se observan en la mayoría de los casos de HMO.

Introduction: Clinical markers of medication overuse headache (MOH) are based on headache classification developed by the International Headache Society (IHS). This classification include only two criteria: frequency of headache days must be 15 or more days per month for at least three or more months; - and the number of days of overuse medication must be either 10 or 15 days per month depending on the type of medication. However, patients often have others distinct associated clinical markers, which are overlooked by most physicians during the initial evaluation. Methodology: This study is a prospective, longitudinal and observational study of 76 patients admitted to DIPRECA´s hospital Headache Unit. They were all diagnosed with, MOH according to the criteria established by the his ICHD III beta.(1) Patients were given standard treatment including detoxification and preventive medications and followed for 6 months. Symptoms of interest were recorded in at each clinical monitoring visit and assessment scales such as Zung, MIDAS, HIT-6 were administered. Results: Overused medications included nonsteroidal anti-inflammatory drugs (NSAIDs), triptans and ergots. The most significant clinical symptoms associated were: awaking in the morning with headache, awaking the patient at dawn by headache, attention difficulties, depression, cervical pain and myofascial pain syndrome. All symptoms significantly improved when treatment began, as did quality of life as measured by MIDAS and HIT-6 scales. Discussion: In evaluating patients with MOH consider both the ICHD III beta diagnostic criteria and the common and specific symptoms seen in most cases of MOH.

Pulsatile Chronotherapeutic Drug Delivery for Controlling Early Morning Surge in Blood Pressure; Effect of Coating on Eplerenone In-vitro, In-vivo Release and Urinary Na/K Ratio

Abstract The objective of the present study was to develop time delayed chronotherapeutic formulation of Eplerenone (Ep) to provide rapid drug release after a pre-determined lag time for the treatment of early morning hypertension. Cyclodextrin complexation was used to prepare fast release Ep core tablets. The developed core tablets were then coated with different rate-controlling polymers using compression coating technique. The developed tablets were evaluated for hardness, friability, drug content and swelling index. The in-vitro drug release was carried out to study the effect of different coating materials on drug release and lag time. Tablets selected for stability study were those showing lag time of 5-7 hours followed by complete drug release; F2, F3, F7, F8, and F12. The in-vivo study was carried out on tablets with the highest t90 as compared to commercial tablets after being administered to healthy human volunteers where plasma Ep and urinary Na/K ratio were determined. Results suggested that this approach was able to provide delayed release Ep formulations that will be useful for patients with morning surge in blood pressure.

A Case of Renal Coloboma Syndrome Caused by Spontaneous Mutation of PAX2 / 罕见病研究

This article reports a case of a child with full-length (paired box family, PAX) PAX2 mutation leading to renal coloboma syndrome. The patient is an 11-year-old boy presented with persistent foamy urine and unexplained renal failure. The boy has suffered from vision decline ever since infancy. Genetic testing confirms the mutation of the PAX2 splice site (c.862-1G > A). Sanger sequencing shows no mutation at this site in his parents and demonstrates a spontaneous mutation. His clinical manifestations also confirms diagnosis of renal coloboma syndrome. The PAX2 mutation was responsible for the boy's progression to end-stage renal disease and extrarenal manifestations.

Effect of Tiaoshen Qianyang acupuncture on blood pressure and sleep quality in patients with stroke-related sleep disorders complicated with hypertension / 中国针灸

OBJECTIVE@#To observe the effect of Tiaoshen Qianyang acupuncture on morning blood pressure, sleep quality and post-stroke nerve function recovery in patients with stroke-related sleep disorders (SSD) complicated with hypertension.@*METHODS@#A total of 120 patients were randomized into an observation group (60 cases) and a control group (60 cases, 1 case dropped off). Both groups were treated with Xingnao Kaiqiao acupuncture (Neiguan [PC 6], Shuigou [GV 26], Sanyinjiao [SP 6], Jiquan [HT 1], Chize [LU 5] and Weizhong [BL 40]). In addition, Tiaoshen Qianyang acupuncture was applied in the observation group, deep needling at Baihui (GV 20) and Sishencong (EX-HN 1) for 5 h. Once a day, 5 times a week, 30 times in total. The morning blood pressure was measured during treatment in the two groups, the Pittsburgh sleep quality index (PSQI) and National Institute of Health stroke scale (NIHSS) scores before and after treatment were observed in the two groups.@*RESULTS@#Compared before treatment, the morning systolic blood pressure (SBP) after treatment were decreased in the two groups (P<0.05), and the morning diastolic blood pressure (DBP) after treatment was decreased in the observation group (P<0.05). The levels of SBP and DBP after treatment in the observation group were lower than the control group (P<0.05). Compared before treatment, the total score of PSQI and NIHSS score after treatment in the observation group were decreased (P<0.01, P<0.05), which were lower than the control group (P<0.01, P<0.05), the decreasing rate of NIHSS score in the observation group was higher than the control group (P<0.05).@*CONCLUSION@#On the basis of Xingnao Kaiqiao acupuncture, Tiaoshen Qianyang acupuncture could improve morning blood pressure and sleep quality for patients with SSD complicated with hypertension, promote the recovery of nerve function.

Effects of morning blood pressure on vascular endothelial function and chronic inflammatory response in the elderly / 中国医师杂志

Objectives:To investigate the effects of morning blood pressure on vascular endothelial function and chronic inflammatory response in the elderly.Methods:349 elderly people aged ≥60 who underwent 24-hour ambulatory blood pressure monitoring in Gaomi Municipal Hospital from April 2018 to October 2019 were selected to detect brachial artery flow mediated vasodilation (FMD) and chronic inflammatory factors [high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-α) and interleukin (IL)-17] levels. According to the results of 24-hour ambulatory blood pressure monitoring, the subjects were divided into normal blood pressure group ( n=108), simple morning hypertension group ( n=114) and hypertension group ( n=127). The clinical data, 24-hour ambulatory blood pressure parameters, vascular endothelial function and inflammatory factors of the three groups were compared. The correlation between 24-hour ambulatory blood pressure parameters and FMD and inflammatory factors was analyzed by partial correlation. Results:Compared with the normal blood pressure group, the simple morning hypertension group and the hypertension group had lower FMD (all P<0.05), higher serum hsCRP and TNF-α , IL-17 levels (all P<0.05). Compared with the simple morning hypertension group, the hypertension group had lower FMD ( P<0.05), higher serum hsCRP, TNF-α and IL-17 levels (all P<0.05). After controlling for age, sex, smoking history, drinking history, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood glucose and 24 h average blood pressure, the morning systolic blood pressure was negatively correlated with FMD ( P<0.05), and positively correlated with serum hsCRP and TNF-α and IL-17 levels (all P<0.05); the morning diastolic blood pressure was negatively correlated with FMD ( P<0.05) and positively correlated with serum hsCRP and TNF-α levels (all P<0.05). Conclusions:Morning blood pressure level is closely related to vascular endothelial function and chronic inflammation level, and is independent of 24-hour average blood pressure. The increase of morning blood pressure may be an important risk factor for endothelial dysfunction and chronic inflammation in the elderly.

Role of testosterone to estradiol ratio in predicting the efficacy of recombinant human chorionic gonadotropin and testosterone treatment in male hypogonadism

ABSTRACT Objective: We aimed to investigate the role of testosterone to estradiol ratio in predicting the effectiveness of human chorionic gonadotropin and testosterone treatments in male hypogonadism. Materials and methods: Thirty-six male patients with hypogonadotropic hypogonadism were included in the study. Seventeen (47.2%) patients received weekly recombinant human choriogonadotropin alpha (hCG) treatment (group-1) and 19 (52.8%) received testosterone replacement therapy (T treatment) every 21 days (group-2). Under these treatments, adequate frequency of morning erection (≥3/week), testosterone to estradiol ratio (T/E), and testicular volume changes were analyzed. Results: The mean age of the patients was 28.5 ± 8.7 years. When the frequency of morning erection (≥3/week) was specified as adequate, the cut-off value for effective T/E ratio was found to be 12.0 (sensitivity 93.8%, specificity 90.0%). There was no significant difference between the treatment groups in terms of total testosterone levels, T/E ratio, or frequency of morning erections (≥3/week) (p > 0.05). However, there was a statistically significant difference between the groups in terms of median left-right testicular volume in favor of group-1 (p < 0,05). Conclusion: In patients with hypogonadism who are under treatment, elevated estradiol-induced erectile dysfunction symptoms may persist even if serum testosterone levels are normal. Testosterone to estradiol ratio can be used as a predictive value in the effective treatment of hypogonadotropic hypogonadism with hCG and T.

Application of SBAR standard communication mode in improving morning shift handover ability of nursing interns in gynecology and obstetrics / 中华医学教育探索杂志

Objective:To explore the application effect of SBAR (situation, background, assessment and recommendation) standard communication mode in the training of morning shift handover ability of nursing interns in gynecology and obstetrics, so as to provide reference for improving the ability of morning shift handover of nursing interns.Methods:This study included in 30 nursing interns in Xuanwu Hospital in 2018 who were selected as the observation group, and 31 nursing interns in 2017 who were selected as the control group. The control group was trained in the traditional way of teaching, while the observation group was trained with SBAR standard communication mode on the basis of traditional teaching. After one month's teaching, the evaluation standard of nursing morning shift handover formulated by our hospital was used as the evaluation index to observe the effectiveness of SBAR mode in improving the morning shift handover ability of nursing interns in obstetrics and gynecology. The scores of morning shift handover of the nursing interns in two groups were compared by independent sample t test. Results:The total average score of nursing interns in the observation group was higher than that of the control group, with statistical significance ( P<0.05). Among them, the scores of shift handover environment, complete content, reasonable process and reasonable time control were higher and the difference was statistically significant ( P<0.05), but there was no significant difference in the scores of emphasis, specialty characteristics and language fluency ( P>0.05). The total average score of bedside handover ability in the observation group was significantly higher than that in the control group, with significant difference ( P<0.05). The scores of shift handover environment, complete content, outlining key points, reflecting specialty characteristics, reasonable process, material preparation and humanistic care were higher than those of the control group, with statistical significance ( P<0.05). Conclusion:SBAR mode can improve the bedside and collective shift handover ability of obstetrics and gynecology nursing interns, and nursing managers can use SBAR mode to cultivate nursing interns' ability of morning shift handover.

Association between glycated hemoglobin and ambulatory blood pressure or heart rate in hypertensive patients / 中南大学学报(医学版)

OBJECTIVES@#To determine the association between glycosylated hemoglobin (HbA1c) and ambulatory blood pressure or heart rate in hypertensive patients.@*METHODS@#A total of 585 patients, who performed ambulatory blood pressure monitoring (ABPM) from September 2018 to April 2019 in Xiangya Hospital, Central South University, were enrolled and assigned into 2 groups (470 in a hypertensive group and 115 in a normal group). HbA1c levels were compared. According to the HbA1c level, the hypertensive group was divided into 2 subgroups: A high HbA1c group (HbA1c≥6.1%, @*RESULTS@#The hypertensive group had higher HbA1c level than the normal group [(6.1±1.3)% vs (5.1±1.7)%, @*CONCLUSIONS@#In hypertensive patients, HbA1c is positively correlated with ambulate blood pressure, blood pressure load, and heart rate, and it has no correlation with blood pressure variability, heart rate variability, or morning blood pressure.

Adherencia terapéutica en hipertensos con incremento matutino de la presión arterial / Therapeutic adherence in hypertensive patients with morning hypertension

Introducción: El incremento matutino de la presión arterial detectado por monitoreo ambulatorio se asocia a daño de órgano blanco y a una mayor incidencia de eventos cardiovasculares. Objetivo: Determinar la adherencia terapéutica en hipertensos con incremento matutino de la presión arterial. Métodos: Se realizó un estudio transversal en 195 pacientes hipertensos ingresados en el servicio de medicina interna del Hospital Universitario Calixto García en el año 2018. Estos mostraron incremento matutino de la presión arterial y se valoró la adherencia terapéutica mediante el test de cumplimiento autocomunicado de Morisky-Green-Levine. Las variables identificadas como predictores relevantes de no adherencia fueron introducidas en un modelo multivariado de regresión logística. Resultados: 63,6 por ciento de los pacientes con incremento matutino de la presión fueron no adherentes, predominaron los pacientes del sexo masculino, 71,6 por ciento. El 84,0 por ciento (p=0,00) de los no adherentes ingerían de 3 a 4 fármacos antihipertensivos, 90,2 por ciento (p=0,00) tomaban 3 o más dosis. 50,5 por ciento de los pacientes tenía un diagnóstico de más de 5 años. Conclusiones: Los pacientes con incremento matutino de presión arterial se caracterizaron por ser no adherentes a la terapéutica antihipertensiva(AU)

Introduction: The morning hypertension detected by ambulatory monitoring is associated with target organ damage and a higher incidence of cardiovascular events. Objective: To determine the therapeutic adherence in hypertensive patients with a morning hypertension. Methods: A cross-sectional study was carried out in 195 hypertensive patients admitted to the internal medicine service at Calixto García University Hospital in 2018. They showed a morning increase of blood pressure and therapeutic adherence was assessed using the self-reported compliance test by Morisky-Green-Levine. The variables identified as relevant predictors of non-adherence were entered in a multivariate logistic regression model. Results: 63.6 percent of the patients with morning hypertension were non-adherent. Male patients predominated. 71.6 percent 84.0 percent (p = 0.00) of the non-adherents had 3 to 4 antihypertensive drugs, 90.2 percent(p = 0.00) took 3 or more doses. 50.5 percent of the patients were diagnosed for more than 5 years. Conclusions: Patients with morning hypertension were described as non-adherent to antihypertensive therapy(AU)

Estafiloma peripapilar, presentación clínica y diagnósticos diferenciales en anomalías congénitas de nervio óptico / Peripapillary staphyloma, clinical presentation, and differential diagnoses in congenital optic nerve anomalies

Un paciente de 3 meses con sospecha de estrabismo presenta al examen una gran anisometropía con -9.50 esfera en su ojo izquierdo y al fondo de ojo destaca una papila alterada similar a la papila de Morning-Glory. Las anomalías congénitas de nervio óptico (ACNO) son un grupo de condiciones que se presentan clínicamente como baja agudeza visual, estrabismo y/o nistagmus. El diagnóstico dife-rencial es clínico y complejo por la sobre posición morfológica entre estas. Los principales diagnósticos diferenciales son la papila deMorning-Glory, el coloboma y la hipoplasia de nervio óptico. Se recomienda manejo multidisciplinario por sus asociaciones sistémicas.

A 3-month-old patient with a suspicion of strabismus on examination has a great anisometropia with -9.50 sphere in his left eye and at the fundus examination an altered papilla similar to the Morning-Glory papilla. Congenital optic nerve abnormalities (ANOC) are a group of conditions that present clinically as low visual acuity, strabismus, and nystagmus. The differential diagnosis is clinical and complex due to the morphological position between them. The main differential diagnoses are the Morning-Glory papilla, the coloboma, and optic nerve hypoplasia. Multidisciplinary management is recommended for its systemic associations.

Conhecimentos, práticas e atitudes frente à anticoncepção de emergência: revisão sistemática / Knowledge, practices and attitudes towards emergency contraception: systematic review / Conocimientos, prácticas y actitudes frente a la anticoncepción de emergencia: revisión sistemática

O objetivo deste estudo é realizar uma revisão sistemática das publicações científicas entre 2007 e 2016 sobre os conhecimentos, as práticas e as atitudes dos participantes frente à anticoncepção de emergência (AE). Efetuou-se uma busca em três bases de dados: Lilacs, BVS-Psi e Scielo, no período de 2007 a 2016. Foram encontrados 260 artigos, sendo incluídos 25 estudos após a avaliação de três juízes independentes. Sobre os conhecimentos acerca da AE, percebeu-se que saber da existência do método não significa ter conhecimento efetivo. Já os determinantes do uso, em geral, são a falha ou o esquecimento de um contraceptivo de rotina. Finalmente, as atitudes frente à AE são mais embasadas num posicionamento pessoal subjetivo que em conhecimento efetivo.

The aim of this study is to conduct a systematic review of the scientific publica-tions between 2007 and 2016 centered on the participants' knowledge, practices and attitudes towards emergency contraception (EC). A survey was done on three databases: Lilacs, BVS-Psi and Scielo, from 2007 to 2016. We found 260 articles, including 25 studies after the evaluation of three independent judges. Regarding the knowledge about AE, it was established that awareness of the method does not equate to effective knowledge about it. Usage is based on failure or forgetting a routine contraceptive. Finally, attitudes toward AE are more grounded in a subjective personal positioning than in effective knowledge.

El objetivo de este estudio es realizar una revisión sistemática de las publi-caciones científicas entre 2007 y 2016 sobre los conocimientos, las prácticas y las actitudes de los participantes frente a la anticoncepción de emergencia (AE). Se efectuó una búsqueda en tres bases de datos: Lilacs, BVS-Psi y Scielo, en el período de 2007 a 2016. Se encontraron 260 artículos, siendo incluidos 25 estudios después de la evaluación de tres jueces independientes. Sobre los conocimientos sobre la AE, se percibió que saber de la existencia del método no significa tener conocimiento efectivo. Los determinantes del uso, en general, son la falla o el olvido del anticonceptivo de rutina. Finalmente, las actitudes frente a la AE son más basadas en un posicionamiento personal subjetivo que en conocimiento efectivo.

El reporte matutino. Una actividad educativa única / Morning report. A unique learning experience

Resumen: El término reporte matutino se utiliza para describir un foro de discusión en donde los médicos presentan y discuten uno o más casos clínicos. Las metas educativas del reporte matutino son, entre otras, la enseñanza basada en casos, facilitar las habilidades de presentación de los becarios y promover la capacidad de toma de decisiones. Además, esta actividad permite evaluar la calidad del cuidado otorgado facilitando acciones que podrían reducir la morbilidad y mortalidad hospitalaria. La discusión de los casos clínicos debe ser en un ambiente propicio; será preciso, por tanto, conocer los elementos del proceso de enseñanza para así cumplir los objetivos de programa académico. Se realiza una revisión bibliográfica de los beneficios teóricos del foro denominado reporte matutino.

Abstract: Morning report is a case based conference where physicians present and discuss clinical cases. While its primary goal is medical education (it was design to improve residents knowledge, leadership, presentation and problem-solving skills), the advantages for actual patients are many and include monitoring care and reviewing management decisions in a supportive, intellectually stimulating and controlled environment. Didactic style education, proper case selection and organizational characteristics are of upmost importance in designing a proper morning report. In this paper it is reviewed the theoretical benefits of implementing a morning report conference in an academic or university hospital.

The impacts of the green aerobics to the homocysteine level in blood and the morning surge in blood pressure of patients who suffer from H-type hypertension as well as ischemic stroke / 中国实用护理杂志

Objective To analyze the effects of green aerobics on serum homocysteine concentration and the morning surge in blood pressure in H-type hypertension patients with ischemic stroke. Methods The 125 patients who suffer from H-type hypertension as well as ischemic stroke were divided into two groups by random digital table method. The control group (60 cases) accepted neurology normal nursing, while the intervention group (65 cases) accepted green aerobics intervention except the neurology normal nursing. The patients′homocysteine level and the morning surge in blood pressure were assessed in two groups. Results Two weeks later, the homocysteine level in the control group was (9.44± 2.07) mmol/L, while the intervention group was (11.62 ± 3.03) mmol/L. The difference between the two groups had statistics significance(t=-5.257, P<0.05). The morning surge in blood pressure was (18.75± 7.51) mmHg(1 mmHg=0.133 kPa), while the control group was (34.07 ± 2.91) mmHg. The difference between the two groups had statistics significance (t =15.761, P <0.05). Conclusions The green aerobics could effectively lower the homocysteine level and the morning surge in blood pressure of patients who suffer from H-type hypertension as well as ischemic stroke. It was an alternative therapy or assistant therapy without side effects.

Evaluation of morning symptoms of chronic obstructive pulmonary disease / 中国医师杂志

According to the traditional view, asthma is a disease with great variability, and its symptoms will change with the circadian rhythm, while it is believed that patients with chronic obstructive pulmonary disease (COPD) will have little change in their symptoms during the stable period.However, a growing number of studies have shown that patients with COPD also have diurnal variability in their symptoms, most commonly morning symptoms, and that morning symptoms are closely related to patients' worse health and quality of life, decreased ability to perform daily activities, and acute exacerbation risk.In recent years, foreign scholars have also developed some measurement scales for quantitative evaluation of morning symptoms of COPD patients, such as Patient Reported Outcomes (PRO)-Morning COPD Symptoms Questionnaire, Early Morning Symptoms of COPD Instruments, Capacity of Daily Living during the Morning questionnaire, Manchester Early Morning Symptoms Index and Chronic Obstructive Pulmonary Disease Morning Symptom Diary.In clinical practice, we should pay more attention to patients' morning symptoms and evaluate them with existing scales.

Evaluation of morning symptoms of chronic obstructive pulmonary disease / 中国医师杂志

According to the traditional view,asthma is a disease with great variability,and its symptoms will change with the circadian rhythm,while it is believed that patients with chronic obstructive pulmonary disease (COPD) will have little change in their symptoms during the stable period.However,a growing number of studies have shown that patients with COPD also have diurnal variability in their symptoms,most commonly morning symptoms,and that morning symptoms are closely related to patients'worse health and quality of life,decreased ability to perform daily activities,and acute exacerbation risk.In recent years,foreign scholars have also developed some measurement scales for quantitative evaluation of morning symptoms of COPD patients,such as Patient Reported Outcomes (PRO)-Morning COPD Symptoms Questionnaire,Early Morning Symptoms of COPD Instruments,Capacity of Daily Living during the Morning questionnaire,Manchester Early Morning Symptoms Index and Chronic Obstructive Pulmonary Disease Morning Symptom Diary.In clinical practice,we should pay more attention to patients'morning symptoms and evaluate them with existing scales.

Effect of acupuncture at Renying (ST 9) on blood pressure in patients with ischemic stroke complicated with essential hypertension / 中国针灸

OBJECTIVE@#To observe the effect of acupuncture at Renying (ST 9) on morning blood pressure, daytime peak blood pressure and 24-hour blood pressure load in patients with ischemic stroke complicated with essential hypertension.@*METHODS@#A total of 80 patients (3 cases dropped off) were randomized into an observation group (39 cases) and a control group (38 cases). acupuncture and nifedipine were given in the control group. On the basis of treatment in the control group, acupuncture at Renying (ST 9) was applied in the observation group, once a day, 6 times a week for 4 weeks. The changes of morning blood pressure, daytime peak blood pressure and blood pressure load were observed before and after treatment in the two groups.@*RESULTS@#Compared before treatment, morning blood pressure, daytime peak blood pressure and blood pressure load after treatment were reduced in the two groups (all 0.05); the changes of morning diastolic pressure, daytime peak blood pressure and blood pressure load in the observation group were larger than those in the control group (all <0.05).@*CONCLUSION@#On the basis of acupuncture and nifedipine, acupuncture at Renying (ST 9) can effectively reduce morning blood pressure, daytime peak blood pressure and blood pressure load in patients with ischemic stroke complicated with essential hypertension.

Effect of " acupuncture" auxiliary therapy on morning blood pressure and blood pressure load in elderly patients with stroke complicated with hypertension / 中国针灸

OBJECTIVE@#To observe the effects of " acupuncture" auxiliary therapy on neurological function, blood pressure load and morning blood pressure in elderly patients with stroke complicated with hypertension, on the basis of " acupuncture" combined with nifedipine.@*METHODS@#Seventy patients with stroke complicated with hypertension were randomly divided into an observation group and a control group, 35 cases in each group. " acupuncture" and conventional nifedipine controlled release tablets were given in the control group. Regarding regaining consciousness with acupuncture, the main acupoint is Shuigou (GV 26), combined with Neiguan (PC 6) and Sanyinjiao (SP 6), retaining needle for 20 min, additionally, the quick needling technique was applied to Shangjiquan (Extra), Chize (LU 5) and Weizhong (BL 40) of the affected side, nifedipine controlled release tablets were orally administered 30 mg once a day for a total of 6 weeks. The " acupuncture" was added on the basis treatment in the observation group, the acupuncture was applied at Renying (ST 9) as the main acupoint, combined with Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3). The strict manipulation quantitative acupuncture was used and the needle was retained for 20 min. Both acupuncture methods were performed once a day, 5 times a week, and continued treatment at intervals of 2 days, 10 times for one course, and a total of 3 courses were needed. The morning blood pressure and 24 h blood pressure load were measured before and after treatment. The National Institute of Health stroke scale (NIHSS) score and the Barthel index (BI) classification were observed before and after treatment.@*RESULTS@#The systolic and diastolic blood pressures were significantly lower than those before treatment in the two groups (all 0.05), and the difference of the diastolic blood pressure before and after treatment in the observation group was higher than that in the control group (<0.01). The systolic and diastolic pressures load in the two groups were lower than those before treatment (all <0.01), and the systolic and diastolic pressures load in the observation group were lower than those in the control group (both <0.05), the difference of systolic and diastolic pressure load before and after treatment in the observation group were higher than those in the control group (both <0.05). After treatment, the NIHSS scores in the two groups were lower than those before treatment (both <0.01). The NIHSS scores in the observation group were lower than those in the control group (<0.05). The difference of NIHSS scores before and after treatment in the observation group was higher than that in the control group (<0.01). After treatment, the BI grading was better than that before treatment in the two groups (both <0.05), and the BI grading in the observation group was superior to that in the control group (<0.05).@*CONCLUSION@#On the basis of " acupuncture" combined with nifedipine controlled release tablets in the treatment of elderly patients with stroke complicated with hypertension, " acupuncture" can further improve the function of nerve and limbs, effectively reduce the morning blood pressure level of elderly patients, especially diastolic blood pressure, and significantly improve systolic blood pressure and diastolic blood pressure load.

The impacts of the green aerobics to the homocysteine level in blood and the morning surge in blood pressure of patients who suffer from H-type hypertension as well as ischemic stroke / 中国实用护理杂志

Objective@#To analyze the effects of green aerobics on serum homocysteine concentration and the morning surge in blood pressure in H-type hypertension patients with ischemic stroke.@*Methods@#The 125 patients who suffer from H-type hypertension as well as ischemic stroke were divided into two groups by random digital table method. The control group (60 cases) accepted neurology normal nursing, while the intervention group (65 cases) accepted green aerobics intervention except the neurology normal nursing. The patients′ homocysteine level and the morning surge in blood pressure were assessed in two groups.@*Results@#Two weeks later, the homocysteine level in the control group was (9.44±2.07) mmol/L, while the intervention group was (11.62±3.03) mmol/L. The difference between the two groups had statistics significance(t=-5.257, P <0.05). The morning surge in blood pressure was (18.75±7.51) mmHg(1 mmHg=0.133 kPa), while the control group was (34.07±2.91) mmHg. The difference between the two groups had statistics significance (t=15.761, P <0.05).@*Conclusions@#The green aerobics could effectively lower the homocysteine level and the morning surge in blood pressure of patients who suffer from H-type hypertension as well as ischemic stroke. It was an alternative therapy or assistant therapy without side effects.