阻塞性睡眠呼吸暂停低通气综合征与脑卒中

阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)作为一种脑卒中独立的危险因素已经广泛受到重视,是脑卒中、冠心病、高血压、充血性心力衰竭等心脑血管疾病的一个主要发病因素.OSAHS引起的频繁血氧饱和度下降和夜间睡眠结构紊乱对心脑血管系统产生严重的危害.本综述主要讨论OSAHS对脑卒中患者的影响和对此类患者的治疗.了解OSAHS和脑卒中之间的联系对于脑卒中的一、二级预防具有重要的意义.     

Parental Alienation Syndrome and the Transsexual Parent

ABSTRACT

Transsexual persons are frequently married and are parents prior to the decision for gender transition. Divorce and issues of child custody or child access follow. This typically volatile area is made the more incendiary when one parent is transgendered. Parental Alienation Syndrome is an unique alliance between one parent and child of denigration and hostility to the other parent. When the transgendered parent is the target, Courts may collaborate in destruction of the transsexual parent-child relationship.     

Comparison of pausing behavior in children who stutter and children who have Asperger syndrome

Purpose

The objective of this research was to compare the number and types of grammatical and non-grammatical silent pauses presented by stutterers and subjects with Asperger syndrome in their narratives.

Method

Ten children who stutter and four participants with Asperger syndrome (mean ages of both groups 10 years) were assessed at the Speech and Language Disorders Department of the Universidade Federal de São Paulo/Brasil. They narrated a story based on a pre-selected sequence of pictures. They were filmed and their productions were analyzed using version 5.0.47 of Praat (http://www.fon.hum.uva.nl/praat/download_win.html). Silent intervals in the speech that ranged from 0.25 to 4 s were considered pauses. The pauses were classified as grammatical and non-grammatical, depending on the words that preceded and followed them.

Results

Both groups presented grammatical and non-grammatical pauses and the former predominated. The children with Asperger syndrome produced a greater number of pauses than the stutterers.Educational objectives: The reader will be able to: (1) characterize the use of pauses in the oral narrative; (2) distinguish a grammatical pause from a non-grammatical pause regarding the use and function; (3) recognize the pattern of pause found in the two populations.     

Maternal sensitivity and overt aggression in young children with Down syndrome

Children with genetic syndromes offer a unique opportunity to combine genetic and environmental approaches to the study of aggression. Children with genetic syndromes associated with developmental delay are at increased risk for behavior problems, but little is known about risk and resilience factors. In this study, we examined maternal sensitivity of mothers of children with Down syndrome using home observations when their children were 2, 3, and 5 years old, and relations with maternal reports and observations of overt aggression at school at age 5. Maternal sensitivity at ages 2 and 3 years did not significantly predict child aggression at age 5, but low maternal sensitivity at age 5 was significantly related to overt aggression at both home and school. By replicating and extending earlier work, this study informs developmental theory and identifies an important maternal variable related to aggression in children with Down syndrome.     

血液净化防治多器官功能障碍综合征的思考

血液净化防治多器官功能障碍综合征已在临床医疗中广泛应用。简要介绍血液净化及多器官功能障碍综合征的相关知识。重点运用科学思维分别从系统论方法、控制论方法、信息方法三方面阐述两者间的内在联系,为临床工作提供新的指导。     

利益相关者分析方法在卫生政策改革中的应用

利益相关者分析作为一种新的方法,已经广泛应用于西方国家的企业管理与卫生政策改革研究和实践中,并取得初步成效,但在我国尚未得到应有的重视.在介绍该方法的基础上,结合我国卫生改革的实际,对利益相关者分析方法在我国卫生政策改革中的应用问题进行了初步的探讨,力图为正处于转型时期的我国卫生改革政策的制定与实施提供新的视角.     

Autism Spectrum Symptomatology in Children: The Impact of Family and Peer Relationships

This study examines the potential impact of family conflict and cohesion, and peer support/bullying on children with autism spectrum disorder (ASD). While such impacts have been established for a range of non-ASD childhood disorders, these findings may not generalize to children with ASD because of unique problems in perspective-taking, understanding others’ emotion, cognitive rigidity, and social reasoning. A structural model-building approach was used to test the extent to which family and peer variables directly or indirectly affected ASD via child anxiety/depression. The sample (N = 322) consisted of parents of children with ASD referred to two specialist clinics. The sample contained parents of children with Autistic Disorder (n = 76), Asperger Disorder (n = 188), Pervasive Disorder Not Otherwise Specified (n = 21), and children with a non-ASD or no diagnosis (n = 37). Parents completed questionnaires on-line via a secure website. The key findings were that anxiety/depression and ASD symptomatology were significantly related, and family conflict was more predictive of ASD symptomatology than positive family/peer influences. The results point to the utility of expanding interventions to include conflict management for couples, even when conflict and family distress is low. Further research is needed on the potentially different meanings of family cohesion and conflict for children with ASD relative to children without ASD.     

非典型性:后现代医学时代一个特征--非典型肺炎流行引发的一些思考

以非典型肺炎为案例,从后现代思维的角度讨论了现代医学的一些认识论问题和非典型肺炎流行引起恐慌的认识原因;提出了超越现代医学的后现代思维策略。     

科学思维的应用与心内重症的诊治

现代科学思维方法中,最具普遍适用意义、最重要的是系统思维方法、模糊思维方法等.介绍尝试将系统思维方法和模糊思维方法在心脏内科重症监护病房常见病诊治中应用的一些体会.     

代谢综合征：动脉粥样硬化危险因素的聚集

代谢综合征是动脉粥样硬化危险因素的聚集状态,包括肥胖、高血压、血糖异常、血脂紊乱等,共同的病理基础是肥胖和胰岛素抵抗。高胰岛素血症、脂肪因子、高血糖、血脂异常和高血压导致内皮细胞损伤和血管炎症,促进动脉粥样硬化发展。提高对代谢综合征的认识有助于从整体观念出发防治肥胖带来的相关疾病。