<strong>Objective: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">To review a case series of 12 women with unexpected h...<strong>Objective: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">To review a case series of 12 women with unexpected heart and lung disorders that occurred during pregnancy and the puerperium, describing for teaching purposes the pitfalls in practice and the lessons learned from this experience. </span><b><span style="font-family:Verdana;">Materials & Methods: </span></b><span style="font-family:Verdana;">We reviewed case files of women with medical and/or hypertensive complications of pregnancy that were evaluated </span><span style="font-family:Verdana;">for medicolegal defense purposes by the first author between 1986-2015.</span> <span style="font-family:Verdana;">Twelve women in these case files experienced unexpected cardiovascular</span><span style="font-family:Verdana;"> and/or cardiopulmonary complications late in pregnancy or early in the puerperium. For each case, the pertinent medical record information was extracted. Im</span><span style="font-family:Verdana;">portant concepts as lessons learned are summarized and referenced for</span><span style="font-family:Verdana;"> teaching purposes. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Five women had undetected preexisting heart disease which acutely deteriorated during the third trimester, four women developed postpartum heart failure related to pregnancy and delivery, and three women </span><span style="font-family:Verdana;">suffered an intrapartum cardiac arrest;none survived. Their case presenta</span><span style="font-family:Verdana;">tions illustrate the importance of obstetric health care professionals being alert to the signs/symptoms of developing cardiopulmonary disease late in pregnancy and following delivery so that timely evaluation and intervention can be accomplished to potentially avoid morbidity and mortality. Diagnostic categories include peripartum heart failure, high-risk chronic hypertension, superimposed preeclampsia, amniotic fluid embolism, pulmonary embolism and Raynaud’s with occult pulmonary hypertension. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">These cases illustrate the diversity of ways that cardiovascular disease can suddenly complicate pregnancy and the early postpartum period. A major part of any effort to enhance safer motherhood is a heightened awareness by obstetric specialists to consider the possibility of heart disease in all maternity patients so that appropriate consultation and collaboration with other specialists might help avoid major maternal morbidity or mortality.</span></span></span></span>展开更多
Objective: To observe the clinical efficacy of acupuncture with medication for post-stroke depression. Methods: A total of 96 patients with post-stroke depression were randomized into an observation group and a contro...Objective: To observe the clinical efficacy of acupuncture with medication for post-stroke depression. Methods: A total of 96 patients with post-stroke depression were randomized into an observation group and a control group, with 48 cases in each group. The control group was treated with oral fluoxetine hydrochloride capsules, and the observati on group was treated with acup un cture on the basis of the treatme nt of the con trol group. After 6 mon ths of treatment, the traditional Chinese medicine (TCM) symptom scores, and Hamilton depression scale (HAMD) component scores and total scores of the two groups before and after treatment were observed, and the clinical efficacy and adverse reaction rate were compared between the two groups. Results: The total effective rate was 95.8% in the observation group and 83.3% in the control group, and the differenee between the two groups was statistically significant (Pv0.05). After treatment, the intra-group differences in TCM symptom scores and HAMD score of both groups were statistically significant (all P<0.01). In the observation group, the scores of in differe nt expressi on, emoti onal restlessness, and sen time ntality in the TCM symptoms were statistically differe nt from those in the control group (all P<0.01). The scores of desperate factor and sleep disorder factor and total score in HAMD in the observation group were significantly different from those in the control group (all P<0.01). The incidenee of adverse reactions was 6.3% in the observation group and 4.2% in the control group, and the differenee was not significant between the two groups (P>0.05). Conclusion: Acupuncture plus medication is an effective method for post-stroke depression, and it can further improve the patient's bad mood.展开更多
文摘<strong>Objective: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">To review a case series of 12 women with unexpected heart and lung disorders that occurred during pregnancy and the puerperium, describing for teaching purposes the pitfalls in practice and the lessons learned from this experience. </span><b><span style="font-family:Verdana;">Materials & Methods: </span></b><span style="font-family:Verdana;">We reviewed case files of women with medical and/or hypertensive complications of pregnancy that were evaluated </span><span style="font-family:Verdana;">for medicolegal defense purposes by the first author between 1986-2015.</span> <span style="font-family:Verdana;">Twelve women in these case files experienced unexpected cardiovascular</span><span style="font-family:Verdana;"> and/or cardiopulmonary complications late in pregnancy or early in the puerperium. For each case, the pertinent medical record information was extracted. Im</span><span style="font-family:Verdana;">portant concepts as lessons learned are summarized and referenced for</span><span style="font-family:Verdana;"> teaching purposes. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Five women had undetected preexisting heart disease which acutely deteriorated during the third trimester, four women developed postpartum heart failure related to pregnancy and delivery, and three women </span><span style="font-family:Verdana;">suffered an intrapartum cardiac arrest;none survived. Their case presenta</span><span style="font-family:Verdana;">tions illustrate the importance of obstetric health care professionals being alert to the signs/symptoms of developing cardiopulmonary disease late in pregnancy and following delivery so that timely evaluation and intervention can be accomplished to potentially avoid morbidity and mortality. Diagnostic categories include peripartum heart failure, high-risk chronic hypertension, superimposed preeclampsia, amniotic fluid embolism, pulmonary embolism and Raynaud’s with occult pulmonary hypertension. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">These cases illustrate the diversity of ways that cardiovascular disease can suddenly complicate pregnancy and the early postpartum period. A major part of any effort to enhance safer motherhood is a heightened awareness by obstetric specialists to consider the possibility of heart disease in all maternity patients so that appropriate consultation and collaboration with other specialists might help avoid major maternal morbidity or mortality.</span></span></span></span>
文摘Objective: To observe the clinical efficacy of acupuncture with medication for post-stroke depression. Methods: A total of 96 patients with post-stroke depression were randomized into an observation group and a control group, with 48 cases in each group. The control group was treated with oral fluoxetine hydrochloride capsules, and the observati on group was treated with acup un cture on the basis of the treatme nt of the con trol group. After 6 mon ths of treatment, the traditional Chinese medicine (TCM) symptom scores, and Hamilton depression scale (HAMD) component scores and total scores of the two groups before and after treatment were observed, and the clinical efficacy and adverse reaction rate were compared between the two groups. Results: The total effective rate was 95.8% in the observation group and 83.3% in the control group, and the differenee between the two groups was statistically significant (Pv0.05). After treatment, the intra-group differences in TCM symptom scores and HAMD score of both groups were statistically significant (all P<0.01). In the observation group, the scores of in differe nt expressi on, emoti onal restlessness, and sen time ntality in the TCM symptoms were statistically differe nt from those in the control group (all P<0.01). The scores of desperate factor and sleep disorder factor and total score in HAMD in the observation group were significantly different from those in the control group (all P<0.01). The incidenee of adverse reactions was 6.3% in the observation group and 4.2% in the control group, and the differenee was not significant between the two groups (P>0.05). Conclusion: Acupuncture plus medication is an effective method for post-stroke depression, and it can further improve the patient's bad mood.
