Prediction of the Duration to Next Admission for an Acute Affective Episode in Patients with Bipolar I Disorder

Objective@#Predicting disease relapse and early intervention could reduce symptom severity. We attempted to identify potential indicators that predict the duration to next admission for an acute affective episode in patients with bipolar I disorder. @*Methods@#We mathematically defined the duration to next psychiatric admission and performed single-variate regressions using historical data of 101 patients with bipolar I disorder to screen for potential variables for further multivariate regressions. @*Results@#Age of onset, total psychiatric admissions, length of lithium use, and carbamazepine use during the psychiatric hospitalization contributed to the next psychiatric admission duration positively. The all-in-one found that hyperlipidemia during the psychiatric hospitalization demonstrated a negative contribution to the duration to next psychiatric admission; the last duration to psychiatric admission, lithium and carbamazepine uses during the psychiatric hospitalization, and heart rate on the discharge day positively contributed to the duration to next admission. @*Conclusion@#We identified essential variables that may predict the duration of bipolar I patients’ next psychiatric admission. The correlation of a faster heartbeat and a normal lipid profile in delaying the next onset highlights the importance of managing these parameters when treating bipolar I disorder.

Diagnosis and treatment of posterolateral elbow dislocation in children / 中华创伤骨科杂志

Objective:To investigate the diagnosis and treatment of posterolateral elbow dislocation in children.Methods:A total of 19 children with posterolateral elbow dislocation were diagnosed and treated at Department of Children's Orthopedics, Sichuan Orthopedic Hospital from April 2018 to April 2021. They were 12 boys and 7 girls, aged from 7 to 14 years (average, 10.9 years). Internal epicondyle avulsion fracture of the humerus was complicated in 11 cases, external epicondyle avulsion fracture of the humerus in 5 cases, capitulum avulsion fracture of the humerus in 3 cases, and fracture of the ulna coronoid process in 4 cases. After evaluation of the elbow stability, stable elbows were treated nonsurgically while the unstable ones complicated with fracture were treated with open reduction and internal fixation. After treatment, the injured limbs were fixated with elbow flexion 90° in forearm pronation position for 4 to 6 weeks.Results:In this group, 4 children received nonsurgical treatment and 15 ones were treated surgically. Internal epicondyle fractures of the humerus were treated by open reduction and internal fixation with Kirschner wire and hollow screws, and external epicondyle avulsion fractures or capitulum avulsion fractures of the humerus by suture fixation with Kirschner wire tension band or absorbable anchors. Three coronal process fractures were treated with plate internal fixation but one coronal process fracture was not treated with internal fixation. All the children were followed up for 6 to 30 months (average, 13.3 months). The last follow-up showed that fractures got united in all children, with no ectopic ossification, fine anatomical relationship of the elbow, and no recurrence of elbow dislocation or instability. The last follow-up showed that the Mayo elbow performance scores (MEPS) ranged from 75 to 100 points, averaging 93.2 points.Conclusions:In the treatment of posterolateral elbow dislocation in children, the key point is to rebuild the stability of the elbow. Non-surgical treatment is recommended for cases of a stable elbow with posterolateral rotation and dislocation while surgical treatment for cases of an unstable elbow because surgery leads to fine functional recovery and efficacy in children.

A review on the role of moisturizers for atopic dermatitis

Effective management of atopic dermatitis (AD) involves the treatment of a defective skin barrier. Patients with AD are therefore advised to use moisturizers regularly. To date, there are few comparative studies involving moisturizers in patients with AD, and no classification system exists to objectively determine which types of moisturizers are best suited to specific AD phenotypes. With this in mind, a group of experts from allergy and immunology, adult and pediatric dermatology, and pediatrics centers within Southeast Asia met to review current data and practice, and to develop recommendations regarding the use of moisturizers in patients with AD within the Asia-Pacific region. Chronicity and severity of AD, along with patient age, treatment compliance, and economic background should all be taken into account when selecting an appropriate moisturizer for AD patients. Other considerations include adjuvant properties of the product, cosmetic acceptability, and availability over the counter. Well-defined clinical phenotypes of AD could optimally benefit from specific moisturizers. It is hoped that future studies may identify such differences by means of filaggrin mutation subtypes, confocal microscopic evaluation, pH, transepidermal water loss or presence of allergy specific IgE. Recommendations to improve the regular use of moisturizers among AD patients include measures that focus on treatment compliance, patient and caregiver education, appropriate treatment goals, avoidance of sensitizing agents, and collaboration with other relevant specialists.

Assessment of Nurses' Nutritional Knowledge and Educational Needs Regarding Stroke Specific Diet Regimens

PURPOSE: Although the prevalence rate of chronic diseases is rapidly increasing due to an unhealthy diet in Korea, nurses may not have enough nutritional knowledge to educate their patients. This study investigated the level of nurses' nutritional knowledge for chronic diseases as well as for strokes, and the needs for nurses' nutritional education. METHODS: This research is a descriptive research conducted from April to August of 2014, on 242 nurses who work with stroke patients, in two tertiary general hospitals in the city of Seoul, South Korea. RESULTS: The average nutritional knowledge score of our subjects was 19.9+/-2.51 (range 12-24). The correct response rate was 83% which was higher than expected. However, many nurses (31-66%) answered incorrectly on items such as 'Drinking low-fat milk is better than whole milk', and 'Seasoning with a large amount of soy sauce instead of salt can reduce sodium consumption'. We also found that nurses who received continuing education regarding nutrition scored higher than those who did not (p=.020). There was no correlation between nutritional knowledge and the need for nutritional education (r=.034, p=.601). CONCLUSION: The level of nutritional knowledge of the nurses was relatively low and irrelevant to the completion of nutrition courses during university or duration of experience. Rather, the relevance was higher when the nurse received nutrition-related training after graduating from university. Our results imply that continuous nutritional education is necessary for hospital nurses.