آسپیرین از جمله داروهای مفیدی است که در بسیاری از موارد در علم پزشکی به کار گرفته میشود و رقیق کننده خون است اما مصرف بیش از آن حد یا به اصطلاح اوردوز آن عوارضی دارد که در این مقاله پزشکی که برای شما بخش های ابتدائی آن را درج کرده ایم با دقت خوبی ذکر میشوند .شما با مطالعه این مقاله و سر زدن به آدرس هایی مثل وبسایت CRISPمی توانید اطلاعات مفیدی را در مورد اوردوز آسپیرین و عوارض و احتیاط های مربوط به آن کسب کنید. این مقاله را می توانید با ارسال ایمیل برای مدیریت وبلاگ مقاله های پزشکی درخواست کنید یا اینکه ترجمه آن را از دوستان ما که در لینک دوستان درج شده اند طلب کنید.
In March 2001, the National Institutes of Health issued the following warning: "The number
of Web sites offering health-related resources grows every day. Many sites provide valuable
information, while others may have information that is unreliable or misleading."1
Furthermore, because of the rapid increase in Internet-based information, many hours can
be wasted searching, selecting, and printing. Since only the smallest fraction of information
dealing with aspirin overdose is indexed in search engines, such as www.google.com or
others, a non-systematic approach to Internet research can be not only time consuming, but
also incomplete. This book was created for medical professionals, students, and members of
the general public who want to know as much as possible about aspirin overdose, using the
most advanced research tools available and spending the least amount of time doing so.
In addition to offering a structured and comprehensive bibliography, the pages that follow
will tell you where and how to find reliable information covering virtually all topics related
to aspirin overdose, from the essentials to the most advanced areas of research. Public,
academic, government, and peer-reviewed research studies are emphasized. Various
abstracts are reproduced to give you some of the latest official information available to date
on aspirin overdose. Abundant guidance is given on how to obtain free-of-charge primary
research results via the Internet. While this book focuses on the field of medicine, when
some sources provide access to non-medical information relating to aspirin overdose,
these are noted in the text.
E-book and electronic versions of this book are fully interactive with each of the Internet
sites mentioned (clicking on a hyperlink automatically opens your browser to the site
indicated). If you are using the hard copy version of this book, you can access a cited Web
site by typing the provided Web address directly into your Internet browser. You may find
it useful to refer to synonyms or related terms when accessing these Internet databases.
NOTE: At the time of publication, the Web addresses were functional. However, some links
may fail due to URL address changes, which is a common occurrence on the Internet.
For readers unfamiliar with the Internet, detailed instructions are offered on how to access
electronic resources. For readers unfamiliar with medical terminology, a comprehensive
glossary is provided. For readers without access to Internet resources, a directory of medical
libraries, that have or can locate references cited here, is given. We hope these resources will
prove useful to the widest possible audience seeking information on aspirin overdose.
مقاله ای که در زیر به شما ارائه می شود با هدف تعیین آستانه های ریسک قلبی عروقی و کرونری که آسپیرین در آن به عنوان عامل پیشگیری اصلی بیماری کرونرری قلبی ایمن محسوب میشود، انجام شده است. این تحقیق از یک فراتحلیل در مورد آزمون های کنترل شده تصادفی آسپیرین برای پیشگیری اولیه برگرفته شده است. برای سفارش ترجمه مقاله به شکل فوری یا عادی می توانید از لینک دوستان ما در بخش پیوندها استفاده کنید و با ذکر بازدید کننده وبلاگ ما بودن از تخفیف مناسب برخوردار شوید.
OBJECTIVE To determine the cardiovascular and coronary risk thresholds at which aspirin for primary prevention of coronary heart disease is safe and worthwhile.
DESIGN Meta-analysis of four randomised controlled trials of aspirin for primary prevention. The benefit and harm from aspirin treatment were examined to determine: (1) the cardiovascular and coronary risk threshold at which benefit in prevention of myocardial infarction exceeds harm from significant bleeding; and (2) the absolute benefit expressed as number needed to treat (NNT) for aspirin net of cerebral haemorrhage and other bleeding complications at different levels of coronary risk.
MAIN OUTCOME MEASURES Benefit from aspirin, expressed as reduction in cardiovascular events, myocardial infarctions, strokes, and total mortality; harm caused by aspirin in relation to significant bleeds and major haemorrhages.
RESULTS Aspirin for primary prevention significantly reduced all cardiovascular events by 15% (95% confidence interval (CI) 6% to 22%) and myocardial infarctions by 30% (95% CI 21% to 38%), and non-significantly reduced all deaths by 6% (95% CI −4% to 15%). Aspirin non-significantly increased strokes by 6% (95% CI −24% to 9%) and significantly increased bleeding complications by 69% (95% CI 38% to 107%). The risk of major bleeding balanced the reduction in cardiovascular events when cardiovascular event risk was 0.22%/year. The upper 95% CI for this estimate suggests that harm from aspirin is unlikely to outweigh benefit provided the cardiovascular event risk is 0.8%/year, equivalent to a coronary risk of 0.6%/year. At coronary event risk 1.5%/year, the five year NNT was 44 to prevent a myocardial infarction, and 77 to prevent a myocardial infarction net of any important bleeding complication. At coronary event risk 1%/year the NNT was 67 to prevent a myocardial infarction, and 182 to prevent a myocardial infarction net of important bleeding.
CONCLUSIONS Aspirin treatment for primary prevention is safe and worthwhile at coronary event risk ⩾ 1.5%/year; safe but of limited value at coronary risk 1%/year; and unsafe at coronary event risk 0.5%/year. Advice on aspirin for primary prevention requires formal accurate estimation of absolute coronary event risk.
وقتی راجع به نقش روان شناسی در بیماران مبتلا به دیابت صحبت می کنیم اولین تصویری که به ذهن می آید تصویر کسی است که در مطب نشسته است و در مورد مشکلات مربوط به دیابت با مشاور صحبت می کند اما این کلیشه با تغییر علوم رفتاری و روان شناسی و آگاهی بیشتر ما از دیابت رنگ باخته است و روش جدیدی در مشاوره روان شناسانه با بیماران دیابتی در پیش گرفته می شود
When one thinks of the role of psychology in diabetes or other types of
health care, the image that comes to mind is that of a patient discussing
emotional dif®culties with a therapist or counsellor in a mental health
setting. This stereotype, based on a referral system for behavioural health
care, was generally accurate for many years. Today, however, the face of
psychology and behavioural science in diabetes is changing, spurred on by
both the development of brief behavioural interventions and the information
technology revolution1±3.
Both the range of issues addressed by psychology and the modalities of
intervention have expanded signi®cantly. Psychologists and other health
professionals are increasingly involved in diabetes care. In some instances,
they are part of multidisciplinary teams providing direct patient care in
medical of®ces. In other cases, they supervise practice innovations, design
computer-assisted intervention programmes or instruct other health profes-
sionals in behaviour change principles and strategies.
There is an important need for psychologists to be more involved in the
diabetes care that takes place in medical of®ces, for three primary reasons.
First, many patients will not or cannot avail themselves of psychological
Psychology in Diabetes Care. Edited by Frank J. Snoek and T. Chas Skinner.
# 2000 John Wiley & Sons Ltd.
Psychology in Diabetes Care, Edited by: Frank J. Snoek & T. Chas Skinner
Copyright # 2000 John Wiley & Sons, Ltd
ISBNs: 0-471-97703-9 (Hardback); 0-470-84656-9 (Electronic)
assistance offered via the traditional referral system. Patients frequently have
many barriers to following through on referrals, including cost, lack of
familiarity with behavioural science, convenience and time commitment
required, and anticipated stigma associated with `seeing a shrink'. Second,
the quality of care provided for diabetes patients in most medical settings is
substantially suboptimal4±6. Almost all population-based studies of the level
of recommended `best practices' received by patients have revealed much
lower than desired rates of clinical services and screening measures4,5. The
rates of preventive services, and especially lifestyle change interventions, are
even lower5,6. Third, patient-centred, motivational interviewing, and patient
activation=empowerment approaches have consistently been found to
produce bene®cial effects, yet such strategies are seldom employed in
either primary care or specialty endocrinological settings. Thus, there is a
compelling need and great opportunity for the application of behavioural
science in medical of®ce settings.
کنترل دیابت در کودکان نیز همانند بزرگسالان از طریق کنترل قند خون صورت می گیرد.اما مشکلاتی از قبیل اصرار بیش از حد و رفتار سختگیرانه برای کنترل قند یا مواردی از این دست می تواند مشکلاتی را از نظر روانی برای کودکان زیر شش سال ایجاد کند. در این بخش از کتاب روان شناسی در درمان دیابت به این موضوع پرداخته شده است و مشکلات و راه حل های این معضل کاملا بررسی شده اند
Once diagnosed, the basic goals ofdiabetes therapy for children under the
age of6 years are similar to those recommended to all children and
adolescents and include the avoidance ofhigh and low blood glucose
levels and the maintenance ofnormal growth and development. However,
due to the continued development ofthe central nervous system, young
children are particularly vulnerable to the debilitating consequences of
recurrent hypoglycaemia.
There is a growing body ofevidence supporting the negative conse-
quencesÐmild cognitive de®citsÐresulting from overly aggressive attempts
to normalize metabolism in young children. Ack et al.24 reported modest
cognitive de®cits in patients with a younger onset oftype 1 diabetes. Others
also reported brain damage as a result ofsevere hypoglycaemia, particularly
in young children25;26. A series ofstudies by Ryan et al.27 29, using a battery
of neurobehavioural tests, identi®ed signi®cant differences between youths
with diabetes compared with control subjects on measures ofverbal intelli-
gence, visual±motor coordination and critical ¯icker threshold. Additionally,
children diagnosed with diabetes under 5 years ofage manifested signi®cant
cognitive de®cits when evaluated during the adolescent years, probably
resulting from symptomatic or asymptomatic hypoglycaemia occurring
earlier in life, before ®nal maturation of the central nervous system. In
another study by Rovet et al.30, children diagnosed under 4 years ofage
scored lower than other children with diabetes diagnosed later in childhood,
and lower than non-diabetic sibling controls on tests ofvisual±spatial
orientation, but not on verbal ability. Hypoglycaemic seizures were found
to occur in greater frequency in the group of children diagnosed under 4
years ofage compared to those diagnosed at older ages, suggesting that
severe hypoglycaemia may impair later cognitive functioning3