Personal and situational factors that predict coping strategies for acute stress among basketball referees

The aim of this study was to establish the ways in which coping style and situational appraisals are related to the consistency of using approach and avoidance coping strategies for skilled Australian basketball referees (n = 133) after three game-related stressful events. The events, ‘making a mistake’, ‘aggressive reactions by coaches or players’ and ‘presence of important others’, were determined from previous research on sources of acute stress among basketball officials. Our findings indicated that: referees exhibited consistent avoidance, but not approach, coping styles; they used more avoidance than approach strategies; and they perceived stress to be positively correlated with approach, and negatively associated with avoidance, coping strategies. These findings suggest that individual differences exist in perceptions of stress (i.e. situational appraisals), controllability and coping styles among moderately and highly skilled basketball referees. The implications for teaching cognitive and behavioural strategies for effective coping with acute stress in basketball officiating are discussed.     

无创正压通气治疗急性左心衰的临床研究

目的：观察机械通气治疗急性左心衰的疗效。方法：60例急性左心衰患者,随机分为常规治疗组和无创通气组,无创通气组在常规治疗基础上加用机械通气治疗,观察通气前后心率（HR）、呼吸频率（RR）,平均动脉压（MAP）及血气分析（pH、PaO2、SaO2、PaCO2）的变化及临床症状的改善情况。结果：机械通气治疗后,患者呼吸困难明显改善,生命体征很快稳定,血气分析指标明显好转。结论：对各种不同原因引起的急性左心衰,机械通气能及时有效的改善患者的临床症状及低氧血症,是抢救急性左心衰的有效措施。     

42例农村急性闭角型青光眼误诊原因分析

青光眼是目前国内外首要致盲眼病之一。在我国发病率为0.21%～1.64%,致盲率为10%～20%。急性闭角型青光眼是一种发病迅速、危害性大、随时导致失明的常见疑难眼病,为老年人主要眼病之一。故对急性闭角型青光眼的早期治疗极为重要,早发现、早诊断和及时有效的治疗可最大限度地挽救视功能。     

Risk of cardiac rupture after acute myocardial infarction is related to a risk of hemorrhage

Although cardiac rupture (CR) is a fatal mechanical complication of acute myocardial infarction (AMI), to date no predictive model for CR has been described. CR has common pathological characteristics with major bleeding. We aimed to investigate the relationship between the risk factors of major bleeding and CR. A total of 10 202 consecutive AMI patients were recruited, and mechanical complications occurred in 72 patients. AMI patients without CR were chosen as control group. Clinical characteristics including bleeding-related factors were compared between the groups. The incidences of free wall rupture (FWR), ventricular septal rupture (VSR), and papillary muscle rupture (PMR) were 0.39%, 0.21%, and 0.09%, respectively, and the hospital mortalities were 92.5%, 45.5%, and 10.0%, respectively. Female proportion and average age were significantly higher in the groups of FWR and VSR than in the control group (P<0.01); higher white blood cell count and lower hemoglobin were found in all CR groups (P<0.01). Compared to the control group, patients with CR were more likely to receive an administration of thrombolysis [26.39% vs. 13.19%, P<0.05], and were less likely to be treated with primary percutaneous coronary intervention (PCI) [41.67% vs. 81.60%, P<0.05]. The major bleeding scores (integer scores) of FWR, VSR, and PMR were (17.70±7.24), (21.91±8.33), and (18.60±7.88), respectively, and were significantly higher than that of the control group (11.72±7.71) (P<0.05). A regression analysis identified age, increased heart rate, anemia, higher white blood cell count, and thrombolysis as independent risk factors of CR, most of which were major bleeding-related factors. The patients with CR have a significantly higher risk of hemorrhage compared to the group without CR. Risk of CR after AMI is related to the risk of hemorrhage.     

Lead toxicity as a result of herbal medication

Awareness about the toxic effects of non-essential metals is still lacking in developing countries. Lead is one among them, which ranks second in the Agency for Toxic Substances and Disease Registry’ s top 20 lists of toxic metals. Some of the herbal medicines prepared from certain roots and leaves are known to contain this toxic metal at alarming levels. We have a case of a person who suffered from the toxic effects of lead such as vomiting and colicky abdominal pain after consuming a herbal remedy for Jaundice treatment. This went unrecognized initially because of the presence of multiple problems like Malaria and Renal calculi. Lead poisoning as causative factor for anemia, vomiting and colic were confirmed only when blood lead concentration was estimated. A combination of chelation therapy and nutritional supplementation was found to be useful in reducing the body lead burden.     

Sleep quality in athletes under normobaric hypoxia equivalent to 1500 m altitude: A polysomnographic study

Abstract

In the present study, we evaluated the duration of slow-wave sleep (Stage 3 and 4) and total delta power (< 3Hz) in all-night non-rapid eye movement (NREM) sleep electroencephalograms (EEGs) of athletes during normobaric hypoxia at simulated altitudes of 1500 m. Seven male athletes slept for two nights in a normoxic condition and one night in an hypoxic condition equivalent to an altitude of 1500 m. Whole-night polysomnographic recordings, thoracic and abdominal motion, nasal and oral airflow, and blood oxygen saturation (SpO₂) were recorded. Visual sleep stage scoring and fast Fourier transformation analyses of EEG were performed using 30-s epochs. Mean and minimum SpO₂ decreased significantly during sleep in the hypoxic condition. Between groups, changes in heart rate, respiratory disturbance measures including apnoea and hypopnoea, slow-wave sleep and total delta power of the all-night NREM sleep EEG were small and non-significant for the hypoxic condition_. However, individual difference in time at an SpO₂ below 90% were large in the hypoxic condition, and both slow-wave sleep and total delta power of all-night NREM sleep EEG decreased in three participants who spent a prolonged time below 90% SpO₂. The present results suggest that monitoring time below 90% SpO₂ is recommended when studying individuals' living-high schedule even under hypoxic conditions equivalent to an altitude of 1500 m.     

白蛋白治疗急性脑出血的疗效分析

目的：观察白蛋白在急性脑出血中的治疗价值。方法：将64例急性脑出血病人随机分成治疗组和对照组，两组均给予甘露醇降颅压及对症治疗。治疗组同时加用白蛋白10g静脉滴注，1次／d，共7d。结果：治疗组比对照组神经功能缺损评分明显改善（P〈0．01）。结论：在脑出血急性期应用白蛋白治疗可明显改善其病情及预后。     

Do abused young children feel less pain?

The objective of this study was to investigate whether acute pain in abused children was under recognized by doctors and nurses compared to children evaluated for accidental injuries. We hypothesize that an abused child’s reaction to physical pain could be an additional symptom of this challenging diagnosis. For the observational prospective case control study in an emergency department, children were eligible when: younger than six years old, the reported trauma occurred within the previous seven days, the trauma comprised a bone injury or burn, and the child was able to express his or her pain. The case group comprised children for whom the medical team reported their abuse suspicions and supporting information to a court, and whose cases of abuse were subsequently confirmed. The control group consisted of children with a plausible cause for their injury and no obvious signs of abuse. The children were matched according to their age and type of trauma. The pain was assessed by doctors and nurses before analgesic administration using a certified pain scale.Among the 78 included children, pain was significantly less recognized in the abused children vs. the controls (relative risk = 0.63; 95% CI: 0.402–0.986; p = 0.04). We observed a discrepancy between the nurses’ and doctors’ scores for the pain assessments (Kappa coefficient = 0.59, 95% CI: 0.40–0.77). Our results demonstrate that pain expression in abused children is under recognized by medical staff. They also suggest that abused children may have reduced pain expression after a traumatic event. Paying particular attention to the pain of abused children may also optimize the analgesic treatment.     

Mechanism of acute pancreatitis complicated with injury of intestinal mucosa barrier

Acute pancreatitis （AP） is a common acute abdomen in clinic with a rapid onset and dangerous pathogenetic condition AP can cause an injury of intestinal mucosa barrier, leading to translocation of bacteria or endotoxin through multiple routes, bacterial translocation （BT）, gutorigin endotoxaemia, and secondary infection of pancreatic tissue, and then cause systemic inflammatory response syndrome （SIRS） or multiple organ dysfunction syndrome （MODS）, which are important factors influencing AP＇s severity and mortality. Meanwhile, the injury of intestinal mucosa barrier plays a key role in AP＇s process. Therefore, it is clinically important to study the relationship between the injury of intestinal mucosa barrier and AP. In addition, many factors such as microcirculation disturbance, ischemical reperfusion injury, excessive release of inflammatory mediators and apoptosis may also play important roles in the damage of intestinal mucosa barrier. In this review, we summarize studies on mechanisms of AP.     

Relationship between resistin level in serum and acute coronary syndrome or stable angina pectoris

Objective To investigate the relationship between serum resistin level and acute coronary syndrome (ACS) or stable angina pectoris (SAP). Methods Sixty-five patients, with coronary artery disease, were enrolled and divided into three subgroupsacute myocardial infarction (AMI), unstable angina pectoris (UAP) and SAP, and 26 healthy people were recruited as controls in the cross-sectional study. Serum resistin levels were determined by ELISA (enzyme-linked immunosorbent assay), and WBC (white blood cell count), hsCRP (high sensitive C-reaction protein), CKmax (maximum ofcreatinkinase), CK-MBmax (maximum of isozyme of creatinkinase) and cTnImax (maximum oftroponin) were measured by standard laboratory methods. Results The serum resistin levels were 4 folds higher in AMI patients, 2.43 folds in UAP patients and 1.12 folds in SAP patients than in the healthy controls (P＜0.05). The resistin levels were also significantly different between AMI [(8.16±0.79) ng/ml], UAP [(5.59±0.75) ng/ml]and SAP [(3.45±0.56) ng/ml] groups (P＜0.01); WBC, hsCRP, CKmax, CK-MBmax and cTnImax were significantly increased in AMI patients over UAP and SAP patients. Spearman analysis showed that serum resistin levels were positively correlated with WBC (r=0.412, P=0.046), hsCRP (r=0.427, P=0.037), CKmax, CK-MBmax and cTnImax (r=0.731, 0.678, 0.656; P＜0.01). ConclusionSerum resistin levels increased with inflammatory factors and myocardial impairment. The results suggest that human resistin might play an important role in the pathogenesis of atherosclerosis and AMI as an inflammatory factor.