• 【利妥昔单抗-CHOP-ESHAP与CHOP-ESHAP-高剂量疗法与常规CHOP化疗治疗高中和高风险侵袭性非霍奇金淋巴瘤。】 复制标题 收藏 收藏
    DOI:10.1080/10428190500525656 复制DOI
    作者列表:Intragumtornchai T,Bunworasate U,Nakorn TN,Rojnuckarin P
    BACKGROUND & AIMS: :With currently available combination chemotherapy regimens, the outcome of the patients newly diagnosed with aggressive non-Hodgkin's lymphoma (NHL) identified as 'high' and 'high-intermediate' risk groups according to the international prognostic index (IPI) is still unsatisfactory and a more innovative therapy is urgently required to improve the survival of the patients. The purpose of this study was to compare the efficacy of rituximab given in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) and ESHAP (etoposide, methylprednisolone, high-dose Ara-C, cisplatin) vs CHOP-ESHAP and upfront high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) vs standard CHOP in patients aged < or = 65 years old newly diagnosed with 'high' and 'high-intermediate' risk aggressive lymphoma enrolled onto two consecutive treatment trials at the institute. Between May 1995 - July 2002, 84 patients, aged 15 - 65 years old, with newly diagnosed aggressive NHL and an age-adjusted IPI of 2 or 3 were enrolled. The median age of the patients was 38 years (range 15 - 65). The baseline demographic features, in particular the major prognostic variables, were similar between the treatment groups. Patients treated with rituximab-CHOP-ESHAP received eight cycles of rituximab (375 mg m(-2) on day 1 of cycles 1 - 6 and days 21 and 28 of cycle 7) plus CHOP (day 3 of cycles 1, 3 and 5) and ESHAP (day 3 of cycles 2, 4 and 6 and day 1 of cycle 7) at 21-day intervals. Patients enrolled onto the CHOP-ESHAP-HDT arm (n = 23) were treated with three courses of CHOP and then switched to two or four cycles of ESHAP followed by HDT. Patients treated with CHOP alone (n = 25) were treated with the standard eight cycles of CHOP. The rate of complete remission was significantly improved with rituximab-CHOP-ESHAP compared with either CHOP-ESHAP-HDT or CHOP alone (67% compared with 44% and 36%, respectively; p = 0.043). With a median follow-up time of 53 months, the 5-year overall survival (OS) was improved by the addition of rituximab-61% with rituximab-CHOP-ESHAP, compared with 43% for CHOP-ESHAP-HDT and 24% for CHOP alone (p = 0.088). Significant increases in failure-free survival (FFS) and disease-free survival (DFS) (61% and 96%), compared with CHOP-ESHAP-HDT (34% and 90%) and CHOP (16% and 44%; p = 0.002 and p < 0.001, respectively) were observed. Compared to CHOP, rituximab-CHOP-ESHAP yielded significantly superior OS (p = 0.014), FFS (p < 0.001) and DFS (p < 0.001). The survivals, however, were not significantly different from patients treated with CHOP-ESHAP-HDT. It is concluded that rituximab-ESHAP-CHOP is superior over standard CHOP and fares comparably to upfront HDT/ASCT in previously untreated patients with aggressive lymphoma. A prospective randomized controlled trial is warranted to confirm these results.
    背景与目标: : 根据目前可用的联合化疗方案,根据国际预后指数 (IPI),新诊断为侵袭性非霍奇金淋巴瘤 (NHL) 的患者的预后仍不令人满意,迫切需要一种更具创新性的疗法来改善患者的生存。本研究的目的是比较利妥昔单抗与CHOP (环磷酰胺,阿霉素,长春新碱,泼尼松) 和ESHAP (依托泊苷,甲基强的松龙,大剂量Ara-C,顺铂与CHOP-ESHAP以及前期大剂量治疗 (HDT) 和自体干细胞移植 (ASCT) 与标准CHOP在新诊断为 “高” 和 “高中间” 风险侵袭性淋巴瘤的年龄 <或 = 65岁的患者中加入了该研究所的两项连续治疗试验。在1995年5月2002年7月之间,纳入了84例年龄在15-65岁之间的新诊断为侵袭性NHL且年龄校正后的IPI为2或3的患者。患者的中位年龄为38岁 (范围15-65岁)。治疗组之间的基线人口统计学特征,特别是主要预后变量相似。利妥昔单抗-CHOP-ESHAP治疗的患者接受8个周期的利妥昔单抗 (第1-6周期的第1天和第7周期的第21天和第28天的375 mg m(-2)) 加CHOP (第1、3和5周期的第3天) 和ESHAP (第2周期的第3天,第4和第6周期以及第7周期的第1天) 间隔21天。纳入CHOP-ESHAP-HDT臂 (n = 23) 的患者接受了三个疗程的CHOP治疗,然后切换到两个或四个周期的ESHAP,然后进行HDT。仅接受CHOP治疗的患者 (n = 25) 接受标准的8个CHOP周期治疗。与单独使用CHOP-ESHAP-HDT或单独使用CHOP相比,利妥昔单抗-CHOP-ESHAP显著提高了完全缓解率 (分别与44% 和36% 相比67%; p = 0.043)。中位随访时间为53个月,通过添加利妥昔单抗-CHOP-ESHAP的rituximab-61 %,改善了5年总生存率 (OS),而CHOP-ESHAP-HDT为43%,CHOP单独为24% (p = 0.088)。与CHOP-ESHAP-HDT (34% 和90%) 和CHOP (16% 和44%; 分别为p = 0.002和p <0.001) 相比,无失败生存率 (FFS) 和无病生存率 (DFS) 显著增加 (61% 和96%)。与CHOP相比,利妥昔单抗-CHOP-ESHAP产生显著优越的OS (p = 0.014) 、FFS (p < 0.001) 和DFS (p <0.001)。然而,生存率与接受CHOP-ESHAP-HDT治疗的患者没有显着差异。结论是,在先前未经治疗的侵袭性淋巴瘤患者中,利妥昔单抗-ESHAP-CHOP优于标准CHOP,与前期HDT/ASCT相比。需要进行前瞻性随机对照试验来证实这些结果。
  • 【抑郁症状是非洲裔美国青少年和年轻人性风险的预测指标。】 复制标题 收藏 收藏
    DOI:10.1016/j.jadohealth.2006.01.015 复制DOI
    作者列表:Brown LK,Tolou-Shams M,Lescano C,Houck C,Zeidman J,Pugatch D,Lourie KJ,Project SHIELD Study Group.
    BACKGROUND & AIMS: PURPOSE:To understand the prospective relationship between depressive symptoms and sexual risk behavior among a community sample of African American adolescents. METHODS:African American adolescents (n = 415) who participated in a larger multi-site human immunodeficiency virus (HIV) prevention program provided baseline data on demographics, psychosocial context and depressive symptoms. At six-month follow-up, data were collected regarding sexual activity in the past 90 days. Multivariate logistic regression was conducted to determine the prospective relationship between depressive symptoms and proportion of condom use while controlling for relevant demographic and contextual factors. RESULTS:The odds that African American adolescents who reported depressive symptoms at baseline would report inconsistent condom use at six-month follow-up was approximately four times greater than that of their peers who did not report depressive symptoms. Older adolescents and females were less likely to use condoms consistently and certain contextual factors, such as less pleasurable expectations about condom use, and living with a partner also heightened HIV/STI risk. CONCLUSIONS:Clinicians should assess for depression symptoms in African American adolescent patients as an indicator of future sexual risk. Prevention interventions that address depressed mood could have a significant impact on later HIV/STI sexual risk behaviors. Further research is needed to understand the effect of depressive symptoms on sexual risk among adolescents of other race/ethnicities and to examine the potential cultural forces that affect this relationship.
    背景与目标:
  • 【[胎儿纤连蛋白作为高危患者样本中早产的标志物]。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Surbek D,Bösiger H,Pavic N,Huber P,Almendral AC,Holzgreve W
    BACKGROUND & AIMS: The accuracy of cervicovaginal fetal fibronectin as a predictor of preterm birth was studied in patients with increased risk for preterm delivery (according to the Creasy-score). In a prospective blind observational study the smear from the posterior fornix vaginae of 56 pregnant patients without PROM was examined using a quantitative immunoassay for the detection of fetal fibronectin. The patients who tested positively for fetal fibronectin had significantly more preterm deliveries than those with a negative result (CHI square-test, p < 0.01, RR 5.1). Overall, sensitivity, specificity, positive and negative predictive values were 56%, 87%, 45% and 91%, respectively. In patients with preterm labor these values were 75%, 87%, 60%, and 93%, respectively. No patient with a negative result delivered preterm during the following two weeks. It is concluded that performing the fetal fibronectin test in patients with preterm labor is useful for the prediction of preterm birth. Routine testing in patients at increased risk (asymptomatic patients) is not recommended for lack of effectiveness.

    背景与目标: 在早产风险增加的患者中研究了宫颈阴道胎儿纤维连接蛋白作为早产预测指标的准确性 (根据Creasy评分)。在一项前瞻性盲观察研究中,使用定量免疫测定法检查了56例无胎膜早破的孕妇的后穹窿阴道涂片,以检测胎儿纤连蛋白。胎儿纤连蛋白检测呈阳性的患者的早产明显多于阴性结果的患者 (卡方检验,p <0.01,RR 5.1)。总体而言,敏感性、特异性、阳性和阴性预测值分别为56% 、87% 、45% 和91%。在早产患者中,这些值分别为75%,87%,60% 和93%。在接下来的两周内,没有阴性结果的患者早产。结论对早产患者进行胎儿纤连蛋白试验对预测早产有一定的帮助。不建议对风险增加的患者 (无症状患者) 进行常规测试,因为缺乏有效性。
  • 【代表性全科样本中晚年失眠的危险因素。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Morgan K,Clarke D
    BACKGROUND & AIMS: BACKGROUND:Insomnia is widely reported and widely treated in general practice, yet relatively little research has focused on the natural history of the condition in primary care settings. As a result, there is at present little information to enable clinicians to assess insomnia risk, or anticipate outcomes in older general practice populations.

    AIM:To estimate, using 8-year longitudinal data, the risk of insomnia onset associated with selected health and lifestyle factors.

    METHOD:Survivors from a nationally representative sample (n = 1042) of elderly people originally interviewed in 1985 were reassessed in 1989 (n = 690) and 1993 (n = 410). At the first follow up in 1989, 84 new cases of insomnia were identified (a weighted incidence rate per person per year at a risk of 3.1%; 95% CI = 2.7-3.5). In logistic regression analyses controlling for age and sex, the risk of insomnia onset was then assessed in relation to the selected factors.

    RESULTS:Three factors assessed in 1985 were significantly and independently related to incident insomnia: psychometric ratings consistent with depressed mood odds ratio (OR) = 4.41; 95% CI = 3.32-5.43); health index scores indicating lower physical health status (OR = 1.19; 95% CI = 1.06-1.31 per unit change in scale score); and moderate and low levels of physical activity (OR = 1.91 and 2.14; 95% CI = 1.91-3.62 and 2.14-3.64 respectively). However, although depressed mood represented a major risk factor, the most likely source of risk was physical rather than mental ill-health.

    CONCLUSIONS:Psychiatric, somatic and lifestyle factors significantly and independently increase the risk of insomnia in older general practice patients. In predicting incident sleep disturbance, these factors exceed in importance the age and sex of patients.

    背景与目标: 背景 : 失眠在一般实践中已被广泛报道和广泛治疗,但针对初级保健机构中该病的自然史的研究相对较少。因此,目前几乎没有信息可以使临床医生评估失眠风险,或预测老年全科医生的结果。
    目标 : 使用8年的纵向数据进行估计,失眠发作的风险与选定的健康和生活方式因素有关。
    方法 : 1989年 (n = 690) 和1993 (n = 410) 重新评估了来自1985年最初接受采访的具有全国代表性的老年人样本 (n = 1042) 的幸存者。在第一次随访1989年,发现了84例新的失眠病例 (每人每年加权发病率,风险为3.1%; 95% CI = 2.7-3.5)。在控制年龄和性别的逻辑回归分析中,然后根据所选因素评估失眠发作的风险。
    结果 : 1985年评估的三个因素与失眠事件显着且独立相关: 符合抑郁情绪优势比 (OR) = 4.41; 95% CI = 3.32-5.43); 健康指数得分表明较低的身体健康状况 (OR = 1.19; 95% CI = 1.06-1.31每单位变化的量表得分); 和中等和低水平的体育活动 (OR = 1.91和2.14; 95% CI分别 = 1.91-3.62和2.14-3.64)。但是,尽管情绪低落是主要的危险因素,但最可能的危险来源是身体健康而不是精神健康不良。
    结论 : 精神病学,躯体和生活方式因素显着且独立地增加了老年全科患者的失眠风险。在预测事件睡眠障碍时,这些因素的重要性超过了患者的年龄和性别。
  • 【肝移植受者巨细胞病毒感染危险因素的多变量分析。】 复制标题 收藏 收藏
    DOI:10.1016/0016-5085(90)90352-2 复制DOI
    作者列表:Gorensek MJ,Carey WD,Vogt D,Goormastic M
    BACKGROUND & AIMS: :Thirty-three consecutive liver-transplant recipients were prospectively studied over a 37-mo period for evidence of cytomegalovirus infection. Sixteen (48%) episodes of cytomegalovirus infection were identified; 9 were primary infections and 7 were recurrent infections. Beginning with patient 8, gamma-globulin prophylaxis was routinely administered to most patients. Twelve potential risk factors for cytomegalovirus infection were evaluated and included pretransplant cytomegalovirus serological status of donor and recipient; recipient's age, sex, race, and liver disease; number and type of blood products transfused; type and intensity of immunosuppression; and occurrence of rejection. The Cox proportional hazards model identified positive donor cytomegalovirus serology as the single most important risk factor for subsequent development of cytomegalovirus infection, regardless of recipient cytomegalovirus serological status. In addition, use of gamma-globulin prophylaxis seemed to be protective against the occurrence of disseminated cytomegalovirus disease.
    背景与目标: : 在37个月的时间内,对33位连续的肝移植受者进行了前瞻性研究,以寻找巨细胞病毒感染的证据。确定了16 (48%) 例巨细胞病毒感染; 9例为原发感染,7例为复发性感染。从患者8开始,大多数患者常规使用丙种球蛋白预防。评估了巨细胞病毒感染的十二个潜在危险因素,包括供体和受者的移植前巨细胞病毒血清学状态; 受者的年龄,性别,种族和肝脏疾病; 输血的血液制品的数量和类型; 免疫抑制的类型和强度; 和排斥的发生。Cox比例风险模型确定阳性供体巨细胞病毒血清学是随后发生巨细胞病毒感染的唯一最重要的危险因素,而与受体巨细胞病毒的血清学状况无关。此外,使用丙种球蛋白预防似乎可以预防弥漫性巨细胞病毒疾病的发生。
  • 【单侧手臂摆动运动对下肢跑步力学的影响与受伤风险有关。】 复制标题 收藏 收藏
    DOI:10.1080/14763141.2016.1269186 复制DOI
    作者列表:Agresta C,Ward CR,Wright WG,Tucker CA
    BACKGROUND & AIMS: :Many field sports involve equipment that restricts one or both arms from moving while running. Arm swing during running has been examined from a biomechanical and physiologic perspective but not from an injury perspective. Moreover, only bilateral arm swing suppression has been studied with respect to running. The purpose of this study was to determine the influence of running with one arm restrained on lower extremity mechanics associated with running or sport-related injury. Fifteen healthy participants ran at a self-selected speed with typical arm swing, with one arm restrained and with both arms restrained. Lower extremity kinematics and spatiotemporal measures were analysed for all arm swing conditions. Running with one arm restrained resulted in increased frontal plane knee and hip angles, decreased foot strike angle, and decreased centre of mass vertical displacement compared to typical arm swing or bilateral arm swing restriction. Stride length was decreased and step frequency increased when running with one or both arms restrained. Unilateral arm swing restriction induces changes in lower extremity kinematics that are not similar to running with bilateral arm swing restriction or typical arm swing motion. Running with one arm restrained increases frontal plane mechanics associated with risk of knee injury.
    背景与目标: : 许多野外运动都涉及限制一只或两只手臂在跑步时移动的设备。从生物力学和生理角度检查了跑步过程中的手臂摆动,但没有从损伤的角度进行检查。此外,仅研究了关于跑步的双侧臂摆动抑制。这项研究的目的是确定限制一只手臂的跑步对与跑步或运动相关的损伤相关的下肢力学的影响。15名健康的参与者以典型的手臂摆动以自我选择的速度奔跑,一只手臂受到约束,而两只手臂受到约束。分析了所有手臂摆动条件下的下肢运动学和时空测量。与典型的手臂摆动或双侧手臂摆动限制相比,用一只手臂约束跑步会导致额面膝关节和髋关节角度增加,脚的打击角度减小,并且质量中心垂直位移减小。在一只或两只手臂受约束的情况下跑步时,步幅减少,步频增加。单侧手臂摆动限制会引起下肢运动学的变化,与双侧手臂摆动限制或典型手臂摆动运动的跑步不相似。一只手臂约束跑步会增加与膝盖受伤风险相关的正面平面力学。
  • 【腰椎骨密度分布的纵向变化可能会增加楔形骨折的风险。】 复制标题 收藏 收藏
    DOI:10.1016/j.clinbiomech.2012.10.005 复制DOI
    作者列表:Giambini H,Khosla S,Nassr A,Zhao C,An KN
    BACKGROUND & AIMS: BACKGROUND:Trabecular bone strength diminishes as a result of osteoporosis and altered biomechanical loading at the vertebral and spinal levels. The spine consists of the anterior, middle and posterior columns and the load supported by the anterior and middle columns will differ across different regions of the spine. Stress shielding of the anterior column can contribute to bone loss and increase the risk of wedge fracture. There is a lack of quantitative data related to regional spinal bone mineral density distribution over time. We hypothesize that there is an increase in the posterior-to-anterior vertebral body bone mineral density ratio and a decrease in whole-body bone mineral density over time. METHODS:Bone mineral density was measured in 33 subjects using quantitative computed tomography scans for L1-L3 vertebrae, region (anterior and posterior vertebral body), and time (baseline and 6 years after). FINDINGS:Lumbar bone mineral density decreased significantly (Δ: ~15%) from baseline to the 6th year visit. Individual vertebra differences over time (L1: ~14%, L2: ~14%, L3: ~17%) showed statistical significance. Anterior bone mineral density change was significantly greater than in the posterior vertebral body region (Δ anterior: ~18%; Δ posterior: ~13%). Posterior-to-anterior bone mineral density ratio was significantly greater in the 6th year compared to baseline values (mean (SD), 1.33 (0.2) vs. 1.23 (0.1)). INTERPRETATION:This study provides longitudinal quantitative measurement of bone mineral density in vertebrae as well as regional changes in the anterior and posterior regions. Understanding bone mineral density distribution over time may help to decrease the risk of wedge fractures if interventions can be developed to bring spine loading to its normal state.
    背景与目标:
  • 【神经性厌食症的全基因组关联研究表明,与瘦素信号失调有关的风险位点。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-017-01674-8 复制DOI
    作者列表:
    BACKGROUND & AIMS: :We conducted a genome-wide association study (GWAS) of anorexia nervosa (AN) using a stringently defined phenotype. Analysis of phenotypic variability led to the identification of a specific genetic risk factor that approached genome-wide significance (rs929626 in EBF1 (Early B-Cell Factor 1); P = 2.04 × 10-7; OR = 0.7; 95% confidence interval (CI) = 0.61-0.8) with independent replication (P = 0.04), suggesting a variant-mediated dysregulation of leptin signaling may play a role in AN. Multiple SNPs in LD with the variant support the nominal association. This demonstrates that although the clinical and etiologic heterogeneity of AN is universally recognized, further careful sub-typing of cases may provide more precise genomic signals. In this study, through a refinement of the phenotype spectrum of AN, we present a replicable GWAS signal that is nominally associated with AN, highlighting a potentially important candidate locus for further investigation.
    背景与目标: : 我们使用严格定义的表型对神经性厌食症 (AN) 进行了全基因组关联研究 (gwa)。表型变异性的分析导致鉴定出一种特定的遗传危险因素,该因素具有全基因组意义 (EBF1中的rs929626 (早期b细胞因子1); P   =   2.04  ×   10-7; Or   =   0.7; 95% 置信区间 (CI)  =   0.61-0.8) 与独立复制 (p   =   0.04),提示一个变异介导的瘦素信号失调可能在AN中起作用。具有变体的LD中的多个snp支持名义上的关联。这表明,尽管AN的临床和病因学异质性已得到普遍认可,但对病例的进一步仔细分类可能会提供更精确的基因组信号。在这项研究中,通过改进AN的表型谱,我们提出了名义上与AN相关的可复制gwa信号,突出了潜在的重要候选基因座,以供进一步研究。
  • 【中国昆明女性青少年性工作者的脆弱性,健康需求和高风险性行为的预测因素。】 复制标题 收藏 收藏
    DOI:10.1136/sextrans-2012-050690 复制DOI
    作者列表:Zhang XD,Temmerman M,Li Y,Luo W,Luchters S
    BACKGROUND & AIMS: OBJECTIVES:This study assessed social and behavioural predictors for sexual risk taking and sexually transmitted infections (STIs) including HIV among adolescent female sex workers (FSWs) from Kunming, China. Additionally, health services needs and use were assessed. METHODS:A cross-sectional survey was conducted in 2010. Using snowball and convenience sampling, self-identified FSWs were recruited from four urban areas in Kunming. Women consenting to participate were administered a semi-structured questionnaire by trained interviewers identified from local peer-support organisations. Following interview, a gynaecological examination and biological sampling to identify potential STIs were undertaken. Descriptive and multivariable logistic regression analyses were performed. RESULTS:Adolescent FSWs had a mean age of 18.2 years and reported numerous non-paying sexual partners with very low rate of consistent condom use (22.2%). Half (50.3%) the respondents had sex while feeling drunk at least once in the past week, of whom 56.4% did not use condom protection. STI prevalence was high overall (30.4%) among this group. Younger age, early sexual debut, being isolated from schools and family, short duration in sex work, and use of illicit drugs were found to be strong predictors for unprotected sex and presence of an STI. Conversely, having access to condom promotion, free HIV counselling and testing, and peer education were associated with less unprotected sex. The majority reported a need for health knowledge, free condoms and low-cost STI diagnosis and treatment. CONCLUSIONS:There is an urgent need to improve coverage, accessibility and efficiency of existing interventions targeting adolescent FSWs.
    背景与目标:
  • 【客观面部皮肤质量分析后,光老化严重程度和皮肤癌风险的自我认知变化。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Bae YC,Bae EJ,Wang JH,Gilchrest BA
    BACKGROUND & AIMS: :

    Background: Despite public education efforts, many people at risk for skin cancer do not practice safe sun behaviors.

    Objective: To determine whether machine-based evaluation of UV-induced alterations (VISIA scan) changes self-assessment of facial photoaging, skin cancer risk, and willingness to improve sun protective habits. In addition, to determine whether VISIA scan analysis reveals differences between those with versus without a history of skin cancer, men versus women, those older than 50 versus less than 50 years of age, and Fitzpatrick skin types I-III versus IV-VI.

    Methods: Volunteers attending a health expo were recruited and queried about their perceived risk of skin cancer and degree of skin photoaging. All participants underwent facial skin quality analysis of both sides of the face, and then completed a follow-up survey.

    Results: Participants' scored self-perceptions of overall skin aging were all statistically significantly worse after VISIA scan analysis. There was no change in perceived skin cancer risk, but most participants expressed intent to improve their sun protection habits.

    Limitations: Limitations to this study include selection bias, recall-misclassification bias, and social desirability bias.

    Conclusion: Intervention with facial skin analysis can positively affect subjects' stated intent to use sun protection, indicating the importance of appearance in these health decisions.

    J Drugs Dermatol. 2017;16(5):453-459.

    .
    背景与目标: :

    背景: 尽管进行了公共教育,但许多有患皮肤癌风险的人并未实践安全的阳光行为。

    目的: 确定基于机器的紫外线诱导改变评估 (VISIA scan) 是否会改变面部光老化的自我评估,皮肤癌风险和改善防晒习惯的意愿。此外,为了确定VISIA扫描分析是否揭示了有皮肤癌病史与没有皮肤癌病史的人,男性与女性,50岁以上与50岁以下的人以及Fitzpatrick皮肤类型i-iii与iv-vi之间的差异。

    方法: 参加健康博览会的志愿者被招募并询问他们对皮肤癌的感知风险和皮肤光老化的程度。所有参与者都对面部两侧进行了面部皮肤质量分析,然后完成了后续调查。

    结果: VISIA扫描分析后,参与者对整体皮肤老化的评分自我认知均在统计学上显着下降。皮肤癌风险的感知没有变化,但大多数参与者表示有意改善他们的防晒习惯。

    局限性: 这项研究的局限性包括选择偏见,召回错误分类偏见和社会期望偏见。

    结论: 面部皮肤分析的干预可以积极影响受试者使用防晒的既定意图,表明外观在这些健康决定中的重要性。

    J药物皮肤科。2017;16(5):453-459。

  • 【退伍军人同时发生自杀意念和暴力冲动的危险因素。】 复制标题 收藏 收藏
    DOI:10.1037/pas0000490 复制DOI
    作者列表:Elbogen EB,Wagner HR,Kimbrel NA,Brancu M,Naylor J,Graziano R,Crawford E,VA Mid-Atlantic MIRECC Workgroup.
    BACKGROUND & AIMS: :Suicide and violence are significant problems in a subset of Iraq/Afghanistan-era veterans. This study investigates how posttraumatic stress disorder (PTSD) and resilience in veterans are associated with suicidal ideation and violent impulses while controlling for known covariates of both adverse outcomes. Structured clinical interviews were conducted of N = 2,543 Iraq/Afghanistan-era U.S. veterans. Compared with veterans denying suicidal ideation or violent impulses (n = 1,927), veterans endorsing both (n = 171) were more likely to meet diagnostic criteria for PTSD, report childhood abuse, combat exposure, physical pain symptoms, and drug misuse, and less likely to endorse self-direction/life purpose. Veterans reporting concurrent suicidal ideation and violent impulses had higher odds of misusing drugs and reporting pain symptoms relative to veterans reporting suicidal ideation only (n = 186) and had lower odds of endorsing self-direction/life purpose compared with veterans reporting violent impulses only (n = 259). The findings underscore the importance of examining drug abuse, physical pain symptoms, and self-direction/life purpose, as well as PTSD and history of trauma, in the context of clinical assessment and empirical research aimed at optimizing risk management of suicide and violence in military veterans. (PsycINFO Database Record
    背景与目标: : 自杀和暴力是伊拉克/阿富汗时代退伍军人的一个重要问题。这项研究调查了退伍军人的创伤后应激障碍 (PTSD) 和韧性如何与自杀意念和暴力冲动相关,同时控制了两种不良结果的已知协变量。对N = 2,543伊拉克/阿富汗时代的美国退伍军人进行了结构化的临床访谈。与否认自杀意念或暴力冲动的退伍军人 (n = 1,927) 相比,支持这两者的退伍军人 (n = 171) 更有可能满足PTSD的诊断标准,报告儿童期虐待,战斗暴露,身体疼痛症状和药物滥用,并且不太可能认可自我指导/生活目标。与仅报告自杀意念的退伍军人相比,报告同时自杀意念和暴力冲动的退伍军人滥用药物和报告疼痛症状的几率更高 (n = 186),并且与仅报告暴力冲动的退伍军人相比,认可自我指导/生活目标的几率更低 (n = 259)。研究结果强调了在旨在优化自杀和暴力风险管理的临床评估和实证研究的背景下,检查药物滥用,身体疼痛症状,自我指导/生活目的以及PTSD和创伤史的重要性。退伍军人。(PsycINFO数据库记录
  • 【用水痘病毒抗原进行皮肤试验以预测带状疱疹的风险。】 复制标题 收藏 收藏
    DOI:10.1017/S0950268812002671 复制DOI
    作者列表:Okuno Y,Takao Y,Miyazaki Y,Ohnishi F,Okeda M,Yano S,Kumihashi H,Gomi Y,Maeda K,Ishikawa T,Mori Y,Asada H,Iso H,Yamanishi K,Shozu Herpes Zoster (SHEZ) Study Group.
    BACKGROUND & AIMS: :The Shozu Herpes Zoster (SHEZ) Study was designed to clarify the incidence of and predictive and immunological factors for herpes zoster in a defined community-based Japanese population. As part of this series, a total of 5683 residents aged ≥50 years received a varicella-zoster virus (VZV) skin test with VZV antigen, and 48 h later, the erythema and oedema were assessed by measuring the longest diameter. The diameters of both the erythema and oedema decreased with the increasing age of the subject. Sixty-three subjects contracted herpes zoster within a year after receiving the VZV skin test. Analysis of the herpes zoster incidence rate vs. the skin test reaction revealed that the shorter the diameter of erythema or oedema, the greater the likelihood of herpes zoster. These results demonstrated that the VZV skin test is an excellent surrogate marker for predicting the risk of herpes zoster.
    背景与目标: : Shozu带状疱疹 (SHEZ) 研究旨在阐明以社区为基础的日本人群中带状疱疹的发生率以及预测和免疫学因素。作为本系列的一部分,共有5683名年龄 ≥ 50岁的居民接受了VZV抗原的水痘病毒 (VZV) 皮肤测试,48小时后,通过测量最长直径来评估红斑和水肿。随着受试者年龄的增长,红斑和水肿的直径均减小。接受VZV皮肤测试后一年内,有63名受试者感染了带状疱疹。对带状疱疹发病率与皮肤测试反应的分析表明,红斑或水肿的直径越短,带状疱疹的可能性越大。这些结果表明,VZV皮肤测试是预测带状疱疹风险的出色替代指标。
  • 【全膝关节置换术后伤口感染的危险因素。】 复制标题 收藏 收藏
    DOI:10.1093/oxfordjournals.aje.a115580 复制DOI
    作者列表:Gordon SM,Culver DH,Simmons BP,Jarvis WR
    BACKGROUND & AIMS: :Wound infections are an infrequent but serious complication of total knee arthroplasty. Between January 1984 and November 1987, 20 of 243 (8.2%) patients at two affiliated hospitals developed surgical wound infections following 259 total knee arthroplasty procedures performed in clean-air operating rooms. Eighteen (90%) of the patients had deep infections; nine required removal of the prosthesis. A single surgeon (surgeon X) was associated with 18 of the procedures that had subsequent infection (risk ratio (RR) = 9.4, 95% confidence interval (CI) 2.2-39), and an investigation was carried out in an effort to explain the difference in infection rates between surgeon X and other surgeons. In a cohort study, stratified analyses identified a preoperative American Society of Anesthesiologists (ASA) physical status class greater than or equal to 3, surgeon X, and early postoperative use of a continuous passive motion device as risk factors associated with surgical wound infection following total knee arthroplasty procedures. Logistic regression analyses identified being a patient operated on by surgeon X with an ASA class greater than or equal to 3 as the only significant independent risk factor for total knee arthroplasty-associated surgical wound infections (RR = 9.3, 95% CI 2.8-31). The effect due to surgeon X could not be explained by receipt or timeliness of administration of antimicrobial prophylaxis, type of prosthesis inserted, duration of operation, postoperative use of continuous passive motion, or underlying etiology of joint disease. The authors conclude that surgical technique and patient's severity of illness were the primary determinants of surgical wound infection after total knee arthroplasty. This study demonstrates the complexity of epidemiologic investigation of surgical wound infections and the importance of considering patient severity of illness when interpreting surgeon-specific infection rates.
    背景与目标: : 伤口感染是全膝关节置换术的罕见但严重的并发症。在1984年1月和1987年11月之间,两家附属医院的243名患者中有20名 (8.2% 名) 在清洁空气手术室中进行了259次全膝关节置换术后发生了手术伤口感染。18 (90%) 名患者患有深部感染; 9名需要移除假体。单个外科医生 (外科医生X) 与18例随后感染的手术相关 (风险比 (RR) = 9.4,95% 置信区间 (CI) 2.2-39),并进行了一项调查,以解释外科医生X与其他外科医生之间感染率的差异。在一项队列研究中,分层分析确定术前美国麻醉医师协会 (ASA) 的身体状况等级大于或等于3,外科医生X,以及术后早期使用连续被动运动装置是与全膝关节置换术后手术伤口感染相关的危险因素。Logistic回归分析确定是由ASA等级大于或等于3的外科医生X手术的患者,是全膝关节置换相关手术伤口感染的唯一重要独立危险因素 (RR = 9.3,95% CI 2.8-31)。不能通过接受或及时施用抗菌药物,插入的假体类型,手术持续时间,术后使用连续被动运动或关节疾病的潜在病因来解释外科医生X的作用。作者得出结论,手术技术和患者的疾病严重程度是全膝关节置换术后手术伤口感染的主要决定因素。这项研究证明了外科伤口感染的流行病学调查的复杂性,以及在解释外科医生特定的感染率时考虑患者疾病严重程度的重要性。
  • 【牙周炎患者牙周治疗前后低密度脂蛋白溶液的非线性光学反应的测量: 心血管风险标志物的评估。】 复制标题 收藏 收藏
    DOI:10.1117/1.jbo.17.11.115004 复制DOI
    作者列表:Monteiro AM,Jardini MA,Giampaoli V,Alves S,Figueiredo Neto AM,Gidlund M
    BACKGROUND & AIMS: :The Z-Scan (ZS) technique in the thermal regime has been used to measure the nonlinear optical response of low-density lipoprotein (LDL). The ZS technique is carried out in LDL from 40 patients with chronic periodontitis before and after three, six, and 12 months of periodontal treatment. Clinical parameters such as probing depths, bleeding on probing, total and differential white blood cells counts, lipid profiles, cytokine levels, and antibodies against oxidized LDL are also determined and compared over time. Before the treatment, the ZS experimental results reveal that the LDL particles of these patients are heavily modified. Only after 12 months of the periodontal treatment, the ZS results obtained reveal behavioral characteristics of healthy particles. This conclusion is also supported by complementary laboratorial analysis showing that the periodontal treatment induces systemic changes in several inflammatory markers.
    背景与目标: : 热状态下的Z扫描 (ZS) 技术已用于测量低密度脂蛋白 (LDL) 的非线性光学响应。ZS技术是在牙周治疗3、6和12个月之前和之后对40例慢性牙周炎患者的LDL进行的。还可以确定临床参数,例如探测深度,探测出血,白细胞总数和差异计数,脂质分布,细胞因子水平以及针对氧化LDL的抗体,并随时间进行比较。治疗前,ZS实验结果表明,这些患者的LDL颗粒已被严重修饰。仅在牙周治疗12个月后,获得的ZS结果才显示出健康颗粒的行为特征。该结论也得到补充实验室分析的支持,该分析表明牙周治疗可引起几种炎症标志物的全身变化。
  • 【睡眠障碍负担及其相关危险因素: 中国HIV感染者抗逆转录病毒治疗的横断面调查。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-017-03968-3 复制DOI
    作者列表:Huang X,Li H,Meyers K,Xia W,Meng Z,Li C,Bai J,He S,Cai W,Huang C,Liu S,Wang H,Ling X,Ma P,Tan D,Wang F,Ruan L,Zhao H,Wei H,Liu Y,Yu J,Lu H,Wang M,Zhang T,Chen H,Wu H
    BACKGROUND & AIMS: :This study evaluated the prevalence and factors associated with sleep disturbance in a large cohort of HIV-infected patients across China. A cross-sectional study was conducted among HIV-infected patients on antiretroviral therapy at 20 AIDS clinics. The Pittsburgh Sleep Quality Index was self-administered by subjects. Socio-demographic characteristics, medical history and HIV-related clinical data were collected. 4103 patients had complete data for analysis. Sleep disturbances were observed in 43.1% of patients. Associated factors in multivariable analysis included psychological factors: anxiety (odds ratio [OR], 3.13; 95% confidence interval [CI], 2.44-4.00; P < 0.001), depression (OR, 2.09; 95% CI, 1.70-2.57; P < 0.001), and both anxiety and depression (OR, 5.90; 95% CI, 4.86-7.16; P < 0.001); sociodemographic factors: MSM (OR, 1.26; 95% CI, 1.04-1.52; P = 0.018), being single (OR, 1.45; 95%CI 1.21-1.74; P < 0.001), higher education (OR, 1.25; 95% CI, 1.03-1.53; P = 0.025); and clinical factors: suboptimal adherence (OR,1.51; 95% CI,1.23-1.85; P < 0.001), regimen-switching (OR, 1.94; 95% CI, 1.12-3.35; P = 0.018), and antidepressant use (OR, 1.98; 95% CI, 1.47-2.67; P = 0.044). Prevalence of sleep disturbance is high in this large Chinese cohort. Associated factors appear related to psychological and social-demographic factors. Health workers may consider routinely assessing sleep disturbances among HIV-infected patients, especially in the first three months after HIV diagnosis, and referring for mental health services, which may positively impact adherence to treatment.
    背景与目标: : 这项研究评估了中国大量HIV感染患者的患病率和与睡眠障碍相关的因素。在20个艾滋病诊所对接受抗逆转录病毒治疗的HIV感染患者进行了横断面研究。匹兹堡睡眠质量指数由受试者自行管理。收集了社会人口统计学特征,病史和与HIV相关的临床数据。4103患者有完整的数据进行分析。在43.1% 患者中观察到睡眠障碍。多变量分析的相关因素包括心理因素: 焦虑 (优势比 [OR],3.13; 95% 置信区间 [CI],2.44-4.00; P  <  0.001),抑郁 (OR,2.09; 95% CI,1.70-2.57; P  <  0.001),焦虑和抑郁 (OR,5.90; 95% CI,4.86-7.16; P  <  0.001); 社会人口统计学因素: MSM (OR,1.26; 95% CI,1.04-1.52; P   =   0.018),单身 (OR,1.45; 95% CI 1.21-1.74; P  <  0.001),高等教育 (OR, 1.25; 95% CI,1.03-1.53; P   =   0.025); 和临床因素: 次优依从性 (OR,1.51; 95% CI,1.23-1.85; P <  0.001),方案转换 (OR,1.94; 95% CI,1.12-3.35; P   =   0.018) 和抗抑郁药的使用 (或,1.98; 95% CI,1.47-2.67; P   =   0.044)。在这个庞大的中国人群中,睡眠障碍的患病率很高。相关因素似乎与心理和社会人口因素有关。卫生工作者可以考虑定期评估HIV感染患者的睡眠障碍,尤其是在HIV诊断后的前三个月,并推荐精神卫生服务,这可能会对治疗依从性产生积极影响。

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