Hasil untuk "Other systems of medicine"

Rudra B. Bhandari, Nidhi Chaudhry

Background: In his Yoga Sutras, Patanjali delineates the principles, processes, practices, and impediments of personal excellence (PE). Unlike Patanjali's perspective, existing conceptualizations and measures of PE are centered on quantifying well-being, leadership effectiveness, professional competence, academic and sports performance, and motivation. However, no yoga-based operationalized model or measure of PE exists to date. Objectives: This study aimed to develop and validate a novel self-report yogic personal excellence inventory (YPEI) with constructs derived from the PYS. Materials and methods: The research was conducted in three rigorous phases to establish YPEI's reliability and validity. Firstly, the YPEI's items were framed and validated for their content by ten experts. Secondly, the first draft of the YPEI was administered to 721 participants for exploratory factor analysis (EFA). The YPEI was then administered to 364 participants to confirm the explored factor structure. Lastly, YPEI's inter-instrument convergent and discriminant validity were assessed by computing correlation with three criteria measures―the vikruti subdosha questionnaire, the vedic personality inventory, and the personal efficacy scale. Conclusion: The model was a good fit with eight factors (psychic incompetence, attachment, despair, existential thinking, somatic illness, laziness, indulgence, and instability). As hypothesized, PE was positively associated with personal efficacy and vedic personality but negatively with vikruti. YPEI will be applicable to measure the psychic and physical morbidities and comorbidities of healthy/unhealthy individuals and prescribe the required personalized bio-psycho-socio-spiritual protocol to minimize them and maximize PE.

Özlem Oğuz, Bülent Toğram

Celia Laur, Natasha Kithulegoda, Nicola McCleary et al.

Background In Ontario, Canada, province-wide initiatives supporting safer opioid prescribing in primary care include voluntary audit and feedback reports and academic detailing. In this process evaluation, we aimed to determine the fidelity of delivery and receipt of the interventions, the observed change strategies used by physicians, potential mechanisms of action, and how complementary the initiatives can be to each other. Method Semi-structured interviews were conducted with academic detailers and with physicians who received both interventions. Academic detailer interviews were coded using the Behavior Change Technique Taxonomy; physician interviews were coded to the Theoretical Domain Framework. Change strategies were summarized based on academic detailer intentions and physician-reported practice changes. Potential mechanisms of action were identified using the Theories and Techniques Tool and the literature. Patient partners informed the interpretation of results through ongoing group discussions of preliminary findings. Results Interviews were conducted with eight academic detailers and 12 physicians. Change strategies described by academic detailers to support physicians’ opioid prescribing included problem solving , instructions on how to perform the behavior , adding objects to the environment , credible source , shaping knowledge , and social support. Physicians mentioned that academic detailing validated current opioid practices or increased their belief about capabilities and their intentions , mediated by increased skills and the impact of environmental context and resources . Potential mechanisms of action included behavioral regulation , behavioral cueing , and general attitudes/beliefs. On its own, receiving the audit and feedback report did not lead to changes in beliefs about prescribing practices; however, for some physicians, it provided validation and reassurance. Physicians saw unrealized potential for complementarity. Conclusions New interventions are often implemented in a complex ecosystem with other competing interventions. In this study, we show how examining the fidelity of the intervention from initial design through to delivery can identify opportunities for potential optimization.

Ümit Karakaş

Amaç: Lavanta yağı, Lamiaceae ailesinin önemli bir üyesi olan lavanta bitkisinden elde edilen ve çeşitli terapötik etkilerle öne çıkan bir uçucu yağdır. Tarihsel olarak, antik medeniyetlerden günümüze kadar antibakteriyel, antienflamatuar, anksiyolitik, antifungal ve yara iyileştirici özellikleri nedeniyle geniş bir kullanım alanı bulmuştur. Lavanta yağının temel bileşenleri olan linalool ve linalil asetat, sinir sistemi üzerinde yatıştırıcı etkiler gösterirken, inflamasyonu ve oksidatif stresi azaltarak çeşitli kronik hastalıkların tedavisine yardımcı olabilmektedir. Yapılan araştırmalar, lavanta yağının nörolojik bozukluklardan kansere kadar uzanan geniş bir etki spektrumu olduğunu ortaya koymuş, ancak bu etkilerin moleküler düzeyde nasıl gerçekleştiği henüz tam olarak anlaşılmamıştır. Çalışmanın amacı güncel literatürü mikroRNA’lar çerçevesinde derlemektir.Yöntem: Çalışmanın içeriği “Lavanta yağı”, “miRNA”, “epigenetik”, “gen ifadesi” anahtar kelimelerinin kombinasyonları ile PubMed, Google akademik, Web of science ve Science direct veri tabanlarından yapılan taramalarla oluşturulmuştur.Bulgular: Son yıllarda, esansiyel yağların genetik ve epigenetik düzeydeki etkileri üzerinde durulmakta ve miRNA'lar ile olası etkileşimleri incelenmektedir. miRNA'ların gen ekspresyonunun düzenlenmesindeki kritik rolü göz önüne alındığında, lavanta yağının özellikle stres, depresyon ve inflamasyonla ilişkili miRNA'ları etkileyerek genetik mekanizmaları modüle etme potansiyeli büyük bir araştırma alanı olarak karşımıza çıkmaktadır. Ancak, bu alandaki literatür eksikliği dikkat çekmektedir. Lavanta yağının terapötik etkilerinin daha iyi anlaşılması, özellikle miRNA'lar üzerindeki etkilerine odaklanan moleküler çalışmaların artmasıyla mümkün olacaktır.Sonuç: Gelecekteki çalışmalar, lavanta yağının moleküler biyolojideki yerini sağlamlaştırabilir ve klinik kullanımı genişletebilir. Bu doğrultuda, lavanta yağının biyolojik mekanizmalarını aydınlatmak, onu hastalıkların tedavisinde daha etkili bir araç haline getirebilir.

Natália Borges Martins, Tatiana Reidel

Em 2022, 33,1 milhões de pessoas são atingidas pela fome, e o acesso à alimentação pela população em situação de rua é dificultado ainda mais no contexto pandêmico da COVID-19. Este artigo busca compreender como está preconizado o acesso à alimentação da pessoa em situação de rua na cidade de Porto Alegre. Trata-se de pesquisa qualitativa em que as entrevistas foram guiadas por um roteiro com questões abertas. As entrevistas aconteceram pelo método bola de neve em que cada entidade sugeriu outra para a entrevista. Assim, foram totalizadas 10 entidades relacionadas ao tema, cujos dados foram analisados por meio da análise de conteúdo. Como critério de inclusão está "a entidade que trabalha com população em situação de rua e alimentação em Porto Alegre". Como resultados, evidencia-se que há quatro formas de acesso à alimentação: ações individuais, de terceiros, do Estado e de projetos sociais. Destaca-se, também, o desmonte de políticas públicas vivenciado no Brasil e a consequente ausência do papel do Estado na garantia do direito à alimentação, o que faz recair sobre a sociedade civil uma responsabilidade que é do Estado. Conclui-se que a alimentação da pessoa em situação de rua é mais proporcionada pelas ações voluntárias, o que sinaliza a transferência de papel do Estado à sociedade civil. Há necessidade de reconhecer a insegurança alimentar como problema emergente e que requer enfrentamento por meio de melhor distribuição de renda, emprego e direitos trabalhistas, assim como políticas sociais públicas, com medidas que ultrapassem a perspectiva filantrópica de entidades. Reitera-se a importância da pesquisa e da produção de conhecimento com vistas a visibilizar a falta de acesso ao direito à alimentação e os desafios de pensar sobre o tema considerando a população em situação de rua.

Mariel C. Magtalas, Patrick Tracy Balbin, Elljhay C. Cruz et al.

Background: Different indigenous peoples in the Philippines still utilize medicinal plants in treating gynecologic diseases. However, there is a lack of information regarding these medicinal plants used in treating gynecologic conditions in the Philippines. Hence, this systematic review compiled the available literature on medicinal plants used for gynecologic healthcare by various indigenous groups in the Philippines. Methods: Ethnobotanical studies that reported medicinal plants used for gynecologic diseases were obtained from OVID Medline, Scopus, and EBSCO CINAHL. A review of titles, abstracts, and articles was done independently by four reviewers. The quality of the studies was assessed using the quality assessment tool for ethnobotanical studies. Results: A total of 27 studies, including 98 different records, that cited the use of medicinal plants to treat gynecologic diseases were included in the qualitative synthesis. Most ethnobotanical studies were conducted in Northern Mindanao, Central Luzon, and Caraga, Philippines. The most common plant family, genus, and species were Fabaceae, Mimosa, and Mimosa pudica L., respectively. Leaves, roots, and stems were predominantly used, commonly prepared by decoction. Medicinal plants reported in ethnobotanical studies were widely used to treat dysmenorrhea (34 ssp.), irregular menstruation (28 spp.), myoma (four spp.), and infertility (four spp.).  A significant proportion of medicinal plants used to treat gynecologic diseases in the Philippines had records of toxicologic (18 spp., 31.03%) or teratogenic (one sp., 1.72%) properties. Other species were reported as both nontoxic and toxic (five spp., 8.62%) and toxic and teratogenic (one sp., 1.72%). However, some were nontoxic or teratogenic (11 sp., 18.97%). In addition, 22 plant species had no data on toxicity or teratogenicity. Conclusion: This systematic review showed that medicinal plants and traditional healing practices are crucial in gynecologic healthcare in the Philippines.

Shakiru Ademola Salami, Hussein Mofomosara Salahdeen, Babatunde Shuaib Anidu et al.

Objectives: Aqueous leaf extract of Tridax procumbens (ALETP) has potent relaxant activity. However, this relaxant activity in respiratory smooth muscle remains uninvestigated. This study investigates the effect of ALETP on the contractile activity of tracheal smooth muscle (TSM) in adult male Wistar rats.Methods : Twelve male Wistar rats divided into 2 groups and were treated with either 100 mg/kg of ALETP (ALETP treatment group) or vehicle (distilled water; control group) through oral gavage for 4 weeks. Dose responses of TSM from the 2 groups to acetylcholine (10–9 to 10–5 M), phenylephrine (10–9 to 10–5 M), and potassium chloride (KCl; 10–9 to 10–4 M) were determined cumulatively. Furthermore, cumulative dose responses to acetylcholine (10–9 to 10–5 M) after pre-incubation of TSM with atropine (10–5 M), L-NAME (10–4 M), indomethacin (10–4 M), and nifedipine (10–4 M), were determined.Results : Treatment with ALETP substantially inhibited TSM contraction stimulated by cumulative doses of acetylcholine, phenylephrine, and KCl. Furthermore, preincubation of TSM from the 2 groups in atropine significantly inhibited contractility in TSM. Incubation in L-NAME and indomethacin also significantly inhibited contractility in TSM of ALETP-treated rats compared to that of controls. Contractile activity of the TSM was also inhibited significantly with incubation in nifedipine in ALETP-treated rats.Conclusion : ALETP enhanced relaxant activity in rat TSM primarily by blocking the L-type calcium channel and promoting endothelial nitric oxide release. ALETP contains agents that may be useful in disorders of the respiratory tract.

Saikripa Raman, Priyanshu Sharma

Abstract Self-efficacy is an important indicator of psychological wellness, devoted to prescribed medications, along with pain-coping strategies in individuals who have chronic pain, a psychological concept described as one’s confidence in performing a specific activity. Poor self-efficacy is an impediment to rehabilitation and predicts long-term impairment. Higher self-efficacy can improve function and prolong physical well-being in people who have chronic pain. Recent findings show that coping mechanisms play a major role in chronic pain adaptation. SE beliefs are a significant determinant of coping habits. This article reviews the theory of SE, the importance of application of SE in treating chronic pain and disability.

Bibi Zahra Hosseini, Abolghasem Aasi-Mozneb, Mohammad Hossein Fallah

سابقه و هدف: به‌دلیل وجود ناهنجاری‌ها و مشکلات روانی و رفتاری در جوامع، روان‌شناسان به‌سمت درمان‌های مختلف برای حل این مشکلات رفته‌اند؛ از جملۀ این درمان‌ها درمان یکپارچۀ توحیدی است که در آن فرد به شخصیتی دست می‌یابد که می‌تواند رفتار ناهنجار خود را اصلاح و از بازگشت مجدد آن جلوگیری کند. در مقالۀ حاضر به بررسی ویژگی‌های این شخصیت خدامحور که با درمان یکپارچۀ توحیدی در فرد ایجاد می‌شود، در متون روان‌شناسی و دینی پرداخته شده است. روش کار: این پژوهش بر پایۀ تحقیقات توصیفی و کیفی و از گونۀ اسنادی با تکیه بر منابع کتابخانه‌ای است. اطلاعات جمع‌آوری‌شده از کتب حدیثی، روان‌شناسی و قرآن و نیز نرم‌افزارهای قرآنی و حدیثی و تفسیری بود که با تحلیل محتوا به بررسی متون پرداخته شد. مؤلفان مقاله هیچ‌گونه تضاد منافعی گزارش نکرده‌اند. یافته‌ها: نتایج به‌دست‌آمده نشان می‌دهد که قرآن این درمان را در 1400 سال قبل بیان کرده است و راه مقابله با مشکلات روانی را دست‌یافتن به شخصیت توحیدیافته‌ای می‌داند که فرد با محورقراردادن خدا در زندگی به آرامش کامل روانی می‌رسد و می‌تواند مشکلات روانی و رفتاری خود را حل نماید. نتیجه‌گیری: بر اساس یافته‌های پژوهش می‌توان گفت افرادی که شخصیت خدامحور دارند علاوه‌بر متعادل‌بودن، در صدد تعالی هستند و تلاششان با نیّت خالص برای قرب الهی است و ادراکی صحیح نسبت به امور مختلف و رفتاری سازگارانه در برخورد با محیط اطراف دارند. درواقع، هر اندازه دین در زندگی افراد نقش بیشتری ایفا کند، شاهد کاهش مشکلات جسمی و روانی و آسیب‌های اجتماعی هستیم.

Neeladrisingha Das, Subhashish Samantaray, Chandrachur Ghosh et al.

Background: Chimaphila umbellata (CU) is a small perennial plant whose roots and leaves are used in the preparation of homeopathic medicines. In this study, the anti-proliferative and apoptotic effects of CU extract, obtained from its homeopathic mother tincture, were evaluated in human breast cancer cell lines. Methods: MTT assay was used to evaluate the dose- and time-dependent cytotoxicity of the extract in MCF-7 and HEK293 cells. The anti-proliferative effect of the extract was evaluated using the clonogenic and wound healing assays. The anti-angiogenic activity of the drug was evaluated using the chick chorioallantoic membrane assay. The mode of cell death was analyzed using Annexin V and PI staining assays through flow cytometry. In addition, the expression patterns of associated genes were evaluated using immunoblot analysis. Results: CU extracts exerted anti-proliferative effect in breast cancer cell line, i.e., MCF-7 cells, by inhibiting their growth and migration. The extract also demonstrated significant anti-angiogenic ability, limiting the de-novo blood vessel growth and development in chick embryos. The extract was found to increase caspase-independent necroptosis by involving RIP1/RIP3 kinases and MLKL proteins. This finding was further confirmed by using NEC-1 (an inhibitor of necroptosis), which significantly abolished the CU extract-induced necroptotic effect. Conclusions: The CU extract exhibits great potential in preventing breast cancer and thus warrants further investigations in vivo.

Faheem, Sanchita Dey, Samridhi Johri et al.

Infections caused by protozoan parasites continue to be a significant cause of morbidity and mortality across the globe, with malaria and leishmaniasis forming the fulcrum of these infections. Decreased effectiveness of existing drugs and increasing cases of drug resistance have called for a multifaceted approach for the development of safe, efficacious, and affordable drugs for malaria and leishmaniasis. The present review article aims to unearth structurally diverse compounds as dual-acting antimalarial and antileishmanial agents. The current review article mainly focuses on the structure, biological activities, and structure-activity relationship (SAR) studies of synthetic and natural compounds that showed promising potential against malaria and Leishmania parasites in the past decade (2011–2021).

Sasan Zardoust, Oya Özdemir, Sevilay Karahan et al.

Objective:A variety of tools are available for myofascial pain syndrome (MPS) treatment; however, it is still one of the most challenging musculoskeletal disorders to treat. This study aimed to determine the effects of kinesio taping (KT) on pain and quality of life in patients with cervical MPS.Materials and Methods:A total of 55 patients were randomly assigned into therapeutic and sham KT groups. In addition to a home-based exercise program, KT was applied on trapezius muscle at 5-day intervals for 20 days. Pain severity and pressure pain threshold (PPT) were assessed by visual analog scale (VAS) and algometer, respectively. Short form-36 (SF-36) scale was used to determine the patients’ health-related quality of life. All participants were evaluated before, immediately after, and 1 month after the end of treatment (follow-up visit).Results:The patient demographic characteristics were found to be similar in both groups. Immediately after the treatment, a statistically significant decrease in VAS and increased PPT and SF-36 scores in both groups were found, with sustained improvement at a follow-up visit. However, no significant difference was determined between the therapeutic and sham KT groups.Conclusion:KT combined with a home-based exercise program appears to decrease pain severity and improve the quality of life of patients with cervical MPS; however, comparable benefits were also obtained from sham therapy.

Sarvesh Kumar Singh, Kshipra Rajoria, Sanjeev Sharma

Vasculitis is chronic inflammation resulting in necrosis of blood vessels due to narrowing or occlusion of the lumen. Here we present a case of 28 yrs old woman suffering from medium size vessel vasculitis since childhood. The patient had purulent skin lesions at lateral aspect of lower limbs, fatigue and pain all over the body. There was complaint of bluish discoloration of extremities, especially in winter season. The patients had history of similar skin lesions in past which were treated by allopathic treatment, but this treatment failed in meeting the expectations of patient. These lesions were not responding to the contemporary treatment since a year. The Ayurvedic diagnosis of the case was established as Siragatavata complicated with Dusta Vrana (~infected wound). She was treated with Vrana Prakshalana (doucing of skin ulceration) with Triphala Kwath for initial 15 days followed by Virechan Karma (purgation therapy) with Tilvaka Ghrita in 20 g dose. Erandmooladi Niruha Basti (enema mainly with decoction) with Bala Taila (oil) Anuvasan Basti (enema with oil) for eight days in Yoga Basti Krama (eight days order of enema) was administered after Virechana Karma. The Ayurvedic oral drugs [Ashwagandhaveleha-10 g, Jwarhar Kashaya- 40 ml, Shatavari Churna (powder)-3 gm, Vidanga Churna-2 g Kaishor Guggulu-500mg and Shilajatwadi Loha-500mg] twice a day for 12 months were also administered in the case. Skin lesions healed after a month of treatment and there was no relapse in more than 18months follow up. Patient was lean and thin and underweight at the beginning of the treatment. There was 4 Kg increase in weight during the treatment. There were no complaints of paresthesia, pain and fatigue after 18 months of treatment. No bluish discoloration was noted during this period. Presently patient is stable with Ayurvedic medications. The case study shows that medium size vessels vasculitis may be managed with Panchakarma procedures and Ayurvedic medication with satisfactory outcome. However, large sample studies are required for definitive conclusion.

Chiung-Yi Huang, Shu-Yu Lin, Tsu-An Hsu et al.

Integrative medicine comprising a tumor-associated antigen vaccine and chemotherapeutic regimens has provided new insights into cancer therapy. In this study, the AB-type diblock copolymers poly(ethylene glycol)–polylactide (PEG–PLA) were subjected to the dispersion of poorly water-soluble molecules in aqueous solutions. The physicochemical behavior of the chemotherapeutic agent DBPR114 in the PEG–PLA-polymeric aqueous solution was investigated by dynamic light scattering (DLS) technology. In vitro cell culture indicated that replacing the organic solvent DMSO with PEG–PLA polymeric micelles could maintain the anti-proliferative effect of DBPR114 on leukemia cell lines. A murine tumor-associated antigen vaccine model was established in tumor-bearing mice to determine the effectiveness of these formulas in inducing tumor regression. The results demonstrated that the therapeutic treatments effectively reinforced each other via co-delivery of antitumor drug/antigen agents to synergistically integrate the efficacy of cancer therapy. Our findings support the potential use of polymeric micellar systems for aqueous solubilization and expansion of antitumor activity intrinsic to DBPR114 and tumor-associated antigen therapy.

Silvana Ceolin, Manuelle Arias Piriz, Marjoriê da Costa Mendieta et al.

RESUMO Objetivo: Analisar as evidências disponíveis nas teses brasileiras sobre os elementos do paradigma sociocrítico na construção do conhecimento e das práticas do cuidado de enfermagem. Método: Revisão integrativa de literatura realizada no Banco de Teses da Coordenadoria de Aperfeiçoamento de Pessoal de Nível Superior e na Biblioteca Digital Brasileira de Teses e Dissertações. Resultados: De um montante de 320 teses, somente 19 apresentaram elementos do paradigma sociocrítico em sua construção, dentre os quais se destacaram o emprego de investigações participativas (principalmente pesquisa-ação), que apresentam interação entre pesquisador e participantes; o uso de técnicas de coleta de dados como grupos focais e círculos de cultura; e referenciais teóricos que permitem analisar os fenômenos em sua complexidade. Conclusão: O suporte do paradigma sociocrítico atribui à enfermagem o caráter de uma ciência prática e a serviço da comunidade, comprometida com a transformação social a partir do empoderamento das pessoas.

Amrita Singh, Samsroz Ahmad Khan, Rajesh Choudhary et al.

Objectives: Several studies have revealed that systemic hypertension is strongly associated with cataractogenesis. However, the pathophysiology and treatment is often unclear. In this study, we evaluated the anti-cataractogenic effect of cinnamaldehyde (CA), a natural organic compound, in rats with fructose-induced hypertension. Methods: The rats were divided into six groups. For six weeks, the normal group received a suspension of 0.5% carboxy methyl cellulose (10 mL/kg/day, p.o.) while five other groups received a 10% (w/v) fructose solution in their drinking water to induce hypertension. By the end of the third week hypertension had been induced in all the animals receiving fructose. From the beginning of the fourth week to the end of the sixth week, one of those five groups (control) continued to receive only 10% (w/v) fructose solution, one group (standard) received ramipril (1 mg/kg/day, p.o.) plus 10% (w/v) fructose solution, and three groups (experimental) received CA at doses of 20, 30, and 40 mg/kg/day p.o., plus 10% (w/v) fructose solution. Blood pressure was measured weekly using a non-invasive blood pressure apparatus. After six weeks, the animals were sacrificed, and the anti-cataractogenic effects on the eye lenses were evaluated. Results: Administration of fructose elevated both the systolic and the diastolic blood pressures, which were significantly reduced by CA at all dose levels. In the control group, a significant increase in the malonaldehyde (MDA) level and decreases in the total protein, Ca2+adenosine triphosphate (ATP)ase activity, glutathione peroxidase, catalase, superoxide dismutase and glutathione levels, as compared to the normal group, were observed. Administration of CA at all doses significantly restored the enzymatic, non-enzymatic, antioxidants, total protein, and Ca2+ATPase levels, but decreased the MDA level, as compared to the control group. Conclusion: The present study revealed that CA modulated the antioxidant parameters of the serum and lens homogenates in hypertension-induced cataractogenic animals.

Drašković Tamara, Pantić Ksenija

INTODUCTION: Background shock syndrome represents an acute generalized disorder perfusion of all organ systems that result in disturbance of metabolism of cells. The time required to develop the shock through all its phases varies from patient to patient. In related to the health status and the ability of the organism to compensate disorder. As shock develops, the process accelerates the circulatory system is unable to provide an adequate amount of blood tissues. The performance cellular hypoxia and cell death. The objective of this paper is to describe the diagnosis, prevention shock and adequately care for patients with respect guide of good clinical medicine in primary health care. DESCRIPTION CASE:A man aged 74 years, was brought in ambulant around 23:15 h. The patient states that he hurt his left lower leg about 19 30 h, the cow kicked him while he was performing work in the barn. Status / conscious, occasionally disoriented, afebrile, pale, cold sweat, respirations Vitals: TA 90/60 mmHg, BLS 22,6mmol/l, HR 131/min., SpO2 92% , auscultatory findings: cardiac arrhythmic action, quieter tones, accelerated, normal breathing sum ECG HR 131 / min, BDG, negative T in V1, signs HLK. Local signs: on the left tibia, lateral side: there is lacero seriously injuries 25/30 cm in length and 5.6 cm depth of extensive bleeding . Tibia fully alterity coloured and cooler than other one: Sanitation injuries solution of NaCl 0.9% tamponade, rewind, amp. metoclopramide iv 1x1, 0.9% NaCl solution 500 ml infusion, Transport, Transportation time from the beginning to hosptal 30 min. DISCUSSION: This case is described to hours of bleeding due to injuries sustained impact of lower leg, cause by animal, in a patient aged 74 years, which has led to the deteriorated state of health, deterioration, generally condition, hypovolemia and origin shock. Considering that the patient did not report the doctor, comes to the development of compensatory phase shock with symptoms, confusion, rapid heart rate, thirst, cold extremities. As shown injured is properly cared for and in the shortest period of time and transported to the secondary health facility. CONCLUSION: Timely reporting patient physician allows easier and faster care for injuries ,and time to provide healing, also prevents possible life-threatening complication.

Erin M. Murphy MD, Jennifer Nichols DO, Steve G. Somkuti MD, PhD et al.

Objective: This study evaluated whether harp therapy reduces levels of stress and improves clinical outcomes in patients undergoing embryo transfer. Design: This prospective randomized trial enrolled 181 women undergoing embryo transfer, who were randomized to harp therapy during embryo transfer or standard treatment. Patients underwent standardized psychological testing and physiologic assessment of stress. Setting: The study was conducted in a reproductive medicine practice. Results: No statistically significant differences were found in the heart and respiratory rates, nor was there a significant difference in event-based anxiety at baseline. Harp therapy had a significantly larger decrease in state anxiety from pre– to post–embryo transfer. Clinical pregnancy was 53% versus 48% for the harp therapy and standard treatment groups, respectively. Conclusion: Harp therapy decreases state, or event-based, anxiety, significantly lowering state scores posttransfer and having a positive effect on acute levels of stress. There was an increased pregnancy rate, but larger sample sizes are needed to evaluate whether harp therapy has an effect on clinical outcomes.

Maria de Fátima Prado Fernandes, Janete Hatsuko Komessu

O presente trabalho trata-se de um estudo de abordagem qualitativa com o objetivo de identificar os desafios dos enfermeiros para assistir às famílias de pacientes fora de possibilidades terapêuticas diante da dor e do sofrimento. A coleta de dados ocorreu no ano de 2008, mediante entrevista semiestruturada, com dezoito enfermeiros que trabalhavam em Unidades de Terapia Intensiva de um hospital privado localizado no município de São Paulo, após aprovação do Comitê de Ética em Pesquisa. Utilizou-se a análise de conteúdo para a avaliação dos dados. Obtiveram-se três categorias: enfrentando os desafios para assistir a família, posicionamento esperado e orientar-se a partir da experiência. Evidenciou-se que, para assistir às famílias, há necessidade dos enfermeiros refletirem a respeito dos valores pessoais e éticos, bem como sobre o processo do morrer. Espera-se que haja troca de experiências entre os enfermeiros já experientes com os que iniciam tal prática no âmbito do cuidar.

Gwon-Il Cho, Jong-Uk Kim, Yun-Jae Lee et al.

The purpose of this study is to evaluate the clinical effect of Hwangryunhaedok-tang Herbal-Acupuncture. Hwangryunhaedok-tang is used in all heating diseases. Chest Heating Sensation is a unique concept in Oriental Medicine. So we applied Hwangryunhaedok-tang Herbal-Acupuncture to treat the Chest Heating Sensation. We used DITI(Digital Infrared Thermographic Imaging) to estimate the temperatures of chest surface for the outcome assessment. We came to know that the chest surface temperatures were all reduced in both cases after Herbal-Acupuncture treatment. The reduced average temperature was 1.5℃ in case 1 and 0.9℃ in case 2. The above result indicates that Hwangryunhaedok-tang Herbal-Acupuncture treatment has an effect on Chest Heating Sensation, thus continuous Hwangryunhaedok-tang Herbal-Acupuncture study will be needed for more clinical applications.