• 【在明视和中视条件下测量LASIK患者视觉性能的功效。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Tang W,Heng WJ,Lee HM,Fam HB,Lai NS
    BACKGROUND & AIMS: INTRODUCTION:The aim of the study was to compare the visual performance of LASIK eyes measured using high-contrast logMAR letter charts under bright (photopic) and dim (mesopic) conditions. MATERIALS AND METHODS:A total of 46 subjects (35 +/- 8 years of age) undergoing LASIK procedures were recruited for the study. The best spectacle-corrected visual acuity (BSCVA) of each subject was measured using the high-contrast ETDRS logMAR chart under photopic and mesopic conditions at 3 visits: preoperative (Pre), 1 month postoperative (Post1) and 3 months postoperative (Post3). The differences in logMAR scores for the right eyes only were analysed for the Pre-Post1 (n = 46), Pre-Post3 (n = 18) and Post1-Post3 (n = 16) comparisons. RESULTS:The logMAR scores of subjects were worse at the 1-month postoperative visit than preoperatively, and improvement in visual performance was seen at the 3-month postoperative visit. These changes in visual performance became more evident under mesopic conditions. The means and standard errors of the differences in logMAR scores for the Pre-Post3 (0.097 +/- 0.020) were slightly larger than those of the Pre-Post1 (-0.067 +/- 0.019) and Post1-Post3 (0.031 +/- 0.012) comparisons. Under mesopic conditions, the visual performance of the subjects was statistically significant for the 3 comparisons, but not under photopic conditions. CONCLUSION:High-contrast logMAR chart performed under mesopic conditions has the potential to replace visual acuity measured under photopic conditions in providing more reliable representation of postoperative visual outcomes of LASIK eyes. Eye doctors should consider performing this vision test routinely to gauge the success of LASIK surgery.
    背景与目标: 简介:本研究的目的是比较在明亮(明暗)和暗淡(近视)条件下使用高对比度logMAR字母图测量的LASIK眼睛的视觉性能。
    材料与方法:共招募了接受LASIK手术的46名受试者(35 /-8岁)。使用高对比度ETDRS logMAR图表在以下3次就诊和视差条件下使用高对比度ETDRS logMAR图表测量每个受试者的最佳眼镜矫正视力(BSCVA):术前(Pre),术后1个月(Post1)和术后3个月(Post3) 。仅比较了Post-Post1(n = 46),Pre-Post3(n = 18)和Post1-Post3(n = 16)比较中的右眼logMAR分数的差异。
    结果:术后1个月随访时受试者的logMAR评分较术前差,术后3个月随访时视力改善。在中视条件下,视觉性能的这些变化变得更加明显。 Post-Post3(0.097 /-0.020)的logMAR得分差异的均值和标准误比Post-Post1(-0.067 /-0.019)和Post1-Post3(0.031 /-0.012)比较的均值和标准误差稍大。在中视条件下,受试者的视觉表现在3个比较中具有统计学意义,但在明视条件下则不然。
    结论:在中视条件下进行的高对比度logMAR图表有可能替代在明视条件下测量的视敏度,以提供更可靠的LASIK眼术后视觉结果的表示。眼科医生应考虑定期进行这种视力测试,以评估LASIK手术的成功率。
  • 【酒精治疗的利用:《全国酒精及相关疾病流行病学调查》的发现。】 复制标题 收藏 收藏
    DOI:10.1016/j.drugalcdep.2006.06.008 复制DOI
    作者列表:Cohen E,Feinn R,Arias A,Kranzler HR
    BACKGROUND & AIMS: BACKGROUND:Epidemiological studies consistently show low rates of alcohol treatment utilization among individuals with an alcohol use disorder (AUD). However, there is not as great consistency in the characteristics that predict alcohol treatment utilization. METHODS:Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we examined attributes associated with treatment utilization among individuals with an AUD. We used stepwise backward selection logistic regression analysis to examine demographic and clinical predictors of treatment utilization, in order to identify opportunities to improve the delivery of services to this population. RESULTS:Only 14.6% of individuals who met lifetime criteria for an AUD reported ever having received alcohol treatment (including self-help group participation). A greater proportion of respondents with both alcohol abuse and dependence (27.9%) reported having received treatment, compared with 7.5% of those with alcohol abuse only and 4.8% of those with alcohol dependence only. Older individuals, men, and those who were divorced, had less education or more lifetime comorbid mood, personality, and drug use disorders were also more likely to have received treatment. CONCLUSIONS:The majority of individuals with an AUD never receive formal alcohol treatment, nor do they participate in self-help groups. Although natural recovery from an AUD is well documented, participation in alcohol treatment is associated with improved outcomes. The data presented here should be taken into account when efforts are made to enhance alcohol treatment utilization.
    背景与目标: 背景:流行病学研究始终显示,在患有酒精使用障碍(AUD)的个体中,酒精治疗的使用率较低。然而,在预测酒精处理利用的特征上并没有很大的一致性。
    方法:使用来自全国酒精及相关疾病流行病学调查(NESARC)的数据,我们检查了与AUD个体之间的治疗利用相关的属性。我们使用逐步向后选择逻辑回归分析来检查治疗利用的人口统计学和临床​​预测指标,以发现改善向该人群提供服务的机会。
    结果:只有14.6%的人符合终身监禁标准,并曾接受过酒精治疗(包括自助小组参与)。既有酗酒又有依赖的受访者中有27.9%的人报告接受过治疗,相比之下,仅酗酒的受访者为7.5%,只有酗酒的受访者为4.8%。年龄较大的个体,男性和已离婚的个体,受教育程度较低,或一生中合并情绪,人格和吸毒障碍的可能性也更高,他们也更有可能接受治疗。
    结论:大多数患有澳元的人从未接受过正式的酒精治疗,也没有参加自助小组。尽管有充分的证据表明可以从澳元自然恢复,但参与酒精治疗与改善结局有关。努力提高酒精处理的利用率时,应考虑此处提供的数据。
  • 【准确衡量非法药物的消费,价格和市场的行为和经济方面的潜力。】 复制标题 收藏 收藏
    DOI:10.1016/j.drugalcdep.2006.08.005 复制DOI
    作者列表:Johnson BD,Golub A
    BACKGROUND & AIMS: :There are numerous analytic and methodological limitations to current measures of drug market activity. This paper explores the structure of markets and individual user behavior to provide an integrated understanding of behavioral and economic (and market) aspects of illegal drug use with an aim toward developing improved procedures for measurement. This involves understanding the social processes that structure illegal distribution networks and drug users' interactions with them. These networks are where and how social behaviors, prices, and markets for illegal drugs intersect. Our focus is upon getting an up close measurement of these activities. Building better measures of consumption behaviors necessitates building better rapport with subjects than typically achieved with one-time surveys in order to overcome withholding and underreporting and to get a comprehensive understanding of the processes involved. This can be achieved through repeated interviews and observations of behaviors. This paper also describes analytic advances that could be adopted to direct this inquiry including behavioral templates, and insights into the economic valuation of labor inputs and cash expenditures for various illegal drugs. Additionally, the paper makes recommendations to funding organizations for developing the mechanisms that would support behavioral scientists to weigh specimens and to collect small samples for laboratory analysis-by providing protection from the potential for arrest. The primary focus is upon U.S. markets. The implications for other countries are discussed.
    背景与目标: :目前对药物市场活动的度量存在许多分析和方法学限制。本文探讨了市场结构和个人用户行为,以提供对非法药物使用的行为和经济(及市场)方面的综合理解,旨在开发改进的测量程序。这涉及了解构成非法分销网络和吸毒者与之互动的社会过程。这些网络是非法毒品的社会行为,价格和市场在何处以及如何相交的地方。我们的重点是仔细衡量这些活动。要建立更好的消费行为衡量标准,就必须与受试者建立更好的融洽关系,这要比一次调查更能实现,以克服扣缴和漏报的情况,并对所涉及的过程有一个全面的了解。这可以通过反复采访和观察行为来实现。本文还描述了可用于指导这一询问的分析进展,包括行为模板,以及对各种非法药物的劳动投入和现金支出的经济估值的见解。此外,该论文还向资助组织提出了建议,以开发机制,以支持行为科学家称量样本并收集小样本进行实验室分析,从而提供保护措施以防止被捕。主要重点是美国市场。讨论了对其他国家的影响。
  • 【比较“现场”条件下从血清分离器和氟化物/草酸钾血液采集管中采集的成对样本中的葡萄糖浓度。】 复制标题 收藏 收藏
    DOI:10.1016/j.clinbiochem.2012.11.027 复制DOI
    作者列表:Fernandez L,Jee P,Klein MJ,Fischer P,Perkins SL,Brooks SP
    BACKGROUND & AIMS: OBJECTIVES:There are no direct comparisons of blood glucose values in samples collected with barrier serum tubes (SST) and NaF/potassium oxalate (NaF/KOx) plasma tubes. Collection of samples in SST tubes can offer considerable savings and specimen processing advantages for national level surveys. DESIGN AND METHODS:Serum and plasma samples were collected under 'field conditions' from a single draw of 3692 individuals participating in the Canadian Health Measures Survey. The samples were analyzed retrospectively using the VITROS GLU Slide method (glucose oxidase-based). RESULTS:There was a high rate of hemolysis in the NaF/KOx tubes (86.2%) while hemolysis was infrequently observed with the SST tubes (2%). Comparing only blood draws where no hemolysis was observed in both tubes (n=495; paired t-test) showed no effect of tube type on serum/plasma glucose concentrations. This was also observed when data was restricted to cases when only SST samples were not hemolyzed (n=3546; paired t-test). CONCLUSIONS:These data show that both collection tubes can be used under survey collection and processing conditions to measure glucose with our assay system with no difference in reported results.
    背景与目标: 目的:尚无直接比较采用屏障血清试管(SST)和NaF /草酸钾(NaF / KOx)血浆试管收集的样本中血糖值的方法。在SST管中收集样品可以为国家级调查提供大量的节省和样品处理的优势。
    设计与方法:在“现场条件”下从参加加拿大卫生措施调查的3692个人中抽取了血清和血浆样品。使用VITROS GLU Slide方法(基于葡萄糖氧化酶)对样品进行回顾性分析。
    结果:NaF / KOx管的溶血率很高(86.2%),而SST管的溶血率很少(2%)。仅比较在两个试管中均未观察到溶血的抽血情况(n = 495;配对t检验)显示试管类型对血清/血浆葡萄糖浓度无影响。当数据仅限于仅不对SST样品进行溶血的情况时(n = 3546;配对t检验),也可以观察到这一点。
    结论:这些数据表明,在我们的测定系统中,两个收集管均可在调查收集和处理条件下用于测量葡萄糖,报道的结果没有差异。
  • 【生产杀菌性透明质酸钠-TiO2仿生复合材料的最佳条件及其表征。】 复制标题 收藏 收藏
    DOI:10.1016/j.ijbiomac.2017.06.016 复制DOI
    作者列表:Safaei M,Taran M
    BACKGROUND & AIMS: :In this research, the creation of optimum conditions for the formation of sodium hyaluronate-TiO2 bionanocomposite and its antibacterial effect on gram positive and gram negative bacteria was evaluated. The Fourier transform infrared spectroscopy spectra, scanning electron microscopy images and energy dispersive X-ray spectroscopy pattern confirmed the formation of the bionanocomposite. Thermogravimetric analysis and differential thermal analysis indicated that the thermal stability rate had significantly improved with formation of the bionanocomposite. Nine experiments were designed based on the Taguchi method by applying different proportions of sodium hyaluronate biopolymer and TiO2 nanoparticles at different stirring times. Bionanocomposite produced under conditions of experiment 5 (TiO2 4mg/ml, sodium hyaluronate 1mg/ml and stirring time of 90min) and experiment 9 (TiO2 8mg/ml, sodium hyaluronate 2mg/ml and stirring time of 60min) completely prevented the growth of Staphylococcus aureus and Escherichia coli. It can be concluded that sodium hyaluronate-TiO2 bionanocomposite can be used as an effective antimicrobial compound in food, pharmaceutical, medical and environmental sectors.
    背景与目标: :在这项研究中,评估了透明质酸钠-TiO2纳米复合材料形成的最佳条件的创建及其对革兰氏阳性和革兰氏阴性细菌的抗菌作用。傅里叶变换红外光谱,扫描电子显微镜图像和能量色散X射线光谱图证实了仿生纳米复合材料的形成。热重分析和差示热分析表明,热稳定性速率随着生物纳米复合材料的形成而显着提高。基于Taguchi方法设计了九个实验,分别在不同的搅拌时间下应用不同比例的透明质酸钠生物聚合物和TiO2纳米颗粒。在实验5(TiO2 4mg / ml,透明质酸钠1mg / ml,搅拌时间90min)和实验9(TiO2 8mg / ml,透明质酸钠2mg / ml,搅拌时间60min)的条件下生产的Bionanocomposite完全阻止了葡萄球菌的生长。金黄色葡萄球菌和大肠杆菌。可以得出结论,透明质酸钠-TiO2纳米复合材料可以在食品,制药,医疗和环境领域用作有效的抗菌化合物。
  • 【预防医院获得性压力伤害的策略的经济评估。】 复制标题 收藏 收藏
    DOI:10.1097/01.ASW.0000520289.89090.b0 复制DOI
    作者列表:Ocampo W,Cheung A,Baylis B,Clayden N,Conly JM,Ghali WA,Ho CH,Kaufman J,Stelfox HT,Hogan DB
    BACKGROUND & AIMS: GENERAL PURPOSE:To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). TARGET AUDIENCE:This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES:After participating in this educational activity, the participant should be better able to:1. Identify the purpose and methods used for this study.2. Compare costs and effectiveness related to preventative strategies for PIs. ABSTRACT:BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective. OBJECTIVE:The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments. DATA SOURCES:Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic ReviewsSELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered. DATA EXTRACTION:Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed. DATA SYNTHESIS:The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered. CONCLUSIONS:Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors' review revealed a need for additional high-quality studies that adhere to commonly used standards of both currently utilized and emerging ways to prevent hospital-acquired PIs.
    背景与目标: 一般目的:提供文献综述中有关压力伤害预防策略(PIs)的经济评估的信息。
    目标听众:此继续教育活动面向医师,医师助理,护士从业人员以及对皮肤和伤口护理感兴趣的护士。
    学习目标/结果:参加此教育活动后,参与者应能够:1。确定本研究的目的和方法2。比较与预防PI有关的成本和有效性。
    摘要:背景:压力伤害(PI)是全球急诊医院普遍且资源密集的挑战。尽管许多预防策略都有可能降低医院获得的PI的成本,但尚不清楚哪种方法最有效。
    目的:作者对预防策略的经济评估文献进行了叙述性回顾,以调查当前发现并确定经济评估中的重要因素。
    数据来源:Ovid,MEDLINE,NHS经济评估数据库和Cochrane系统评价数据库选择标准:考虑了潜在相关的原始研究文章和系统评价。
    数据摘录:选择标准包括英语撰写的文章,提供有关急性护理中PI预防策略的成本或经济评估的数据,并于2004年1月至2015年9月之间发表。如何处理《综合卫生经济评估报告标准》清单中的项目。
    数据综合:这些搜索确定了192篇参考文献。选择了33篇原创文章进行全文审查。这些文章中有19个提供了对干预措施,研究方法和所考虑结果的清晰描述。
    结论:现有文献的局限性阻止了关于预防PI的各种方法的相对经济价值的确切结论。作者的评论表明,有必要进行更多高质量的研究,这些研究既要遵循目前使用的标准,又要采用新的方法来预防医院获得的PI。
  • 【医疗条件下的精神病:对利培酮的反应。】 复制标题 收藏 收藏
    DOI:10.1016/s0163-8343(97)89884-2 复制DOI
    作者列表:Furmaga KM,DeLeon OA,Sinha SB,Jobe TH,Gaviria M
    BACKGROUND & AIMS: We report the response to risperidone in seven hospitalized, adult patients who presented psychotic symptoms etiologically related to a general medical condition. The conditions included brain surgery in two, and anticardiolipin syndrome, renal failure, epilepsy, lupus, and metastatic carcinoma in one each. Four patients had failed previous treatment with at least one typical antipsychotic agent. Response to risperidone was assessed by the Brief Psychiatric Rating Scale (BPRS). Serum was collected for measurement of steady-state trough risperidone and 9-hydroxyrisperidone concentrations at effective doses in three patients. Amelioration of psychotic symptoms was noted in all seven patients. Mean (+/- SD) BPRS scores were reduced significantly from baseline (63.0 +/- 15.1) to endpoint (27.0 +/- 3.5; p < 0.01). The mean effective daily dose of risperidone was 3.1 +/- .7 mg and time to response was 4.7 +/- 2.4 days. Risperidone was not present at detectable concentrations in the three patients studied. The mean steady-state trough serum concentration of 9-hydroxyrisperidone in the three patients assessed was 20.3 +/- 9.8 ng/ml. These preliminary findings, which suggest that risperidone is a safe and effective agent in patients with psychotic symptoms due to various medical conditions, need to be confirmed by randomized, antipsychotic comparison trials involving a larger number of patients.

    背景与目标: 我们报告了七名住院的成年患者对利培酮的反应,这些患者在病因学上呈现出与一般医疗状况相关的精神病症状。这些疾病包括脑外科手术两次,抗心磷脂综合症,肾衰竭,癫痫,狼疮和转移性癌各一次。四名患者先前接受了至少一种典型的抗精神病药治疗失败。通过简要精神病评定量表(BPRS)评估对利培酮的反应。收集血清用于在三位患者中以有效剂量测量稳态谷色利培酮和9-羟基利培酮的浓度。在所有七名患者中均发现精神病症状得到改善。从基线(63.0 /-15.1)到终点(27.0 /-3.5; p <0.01),平均(±SD)BPRS得分显着降低。利培酮的平均有效日剂量为3.1 /-.7 mg,响应时间为4.7 /-2.4天。在研究的三位患者中,未检测到利培酮的存在。在评估的三名患者中,9-羟基利培酮的平均稳态谷浓度为20.3 /-9.8 ng / ml。这些初步发现表明,利培酮是因各种医疗条件而出现精神病症状的患者的安全有效药物,需要通过涉及更多患者的随机抗精神病药物比较试验来证实。

  • 【神经免疫疾病的社会经济方面。】 复制标题 收藏 收藏
    DOI:10.1007/s00415-006-5015-x 复制DOI
    作者列表:Rieckmann P
    BACKGROUND & AIMS: :Neuroimmunological diseases often have a chronic course and a high socio-economic impact, as most of them occur in younger patients and result in progressing disability and loss of work force. Although for many conditions different treatment strategies are available no sufficient data exist to give a reasonable account on the cost effectiveness of individual therapies. Treatment decision should primarily be guided by evidence from high quality clinical studies and-if available-from direct head-to-head trials and cost-effectiveness analysis.
    背景与目标: 神经免疫疾病通常具有慢性病程,并且对社会经济影响很大,因为它们大多发生在年轻的患者中,并导致残疾的发展和劳动力的丧失。尽管对于许多情况,可以使用不同的治疗策略,但没有足够的数据来合理说明各个疗法的成本效益。治疗决策应首先以高质量临床研究的证据为指导,如果可以的话,也应以直接的直接面对面试验和成本效益分析为依据。
  • 【性少数成年人的睡眠剥夺和慢性健康状况。】 复制标题 收藏 收藏
    DOI:10.1080/15402002.2017.1342166 复制DOI
    作者列表:Dai H,Hao J
    BACKGROUND & AIMS: OBJECTIVES:To examine associations between sleep duration and health outcomes among distinct groups of sexual minority adults. METHODS:Using data from the 2014 Behavioral Risk Factor Surveillance System, we compared sleep duration (very short: ≤ 5 hr; short: 6 hr; normal: 7-8 hr; and long: ≥ 9 hr per day) between cisgender straight adults and distinct groups of sexual minorities. We further examined associations between sleep duration and 10 chronic health conditions among sexual minorities. RESULTS:Of 146,893 respondents, 142,507 (96.2%) were cisgender straight, and 4,386 (3.8%) were lesbian, gay, bisexual, transgender (LGBT). Overall, 17.3% of LGBT respondents reported very short sleep per day, compared with 12.2% for cisgender straight respondents (p < 0.0001). Among LGBT populations, the prevalence of very short sleep varied significantly among distinct groups, ranging from 13.2% among transgender female to male adults to 35.5% among transgender gender nonconforming adults. Very short sleep was further associated with increased odds of having stroke (aOR = 4.1, 95% CI [2.2-7.6]), heart attack (aOR = 3.0, CI [1.6-5.8]), coronary heart disease (aOR = 3.1, 95% CI [1.5-6.2]), asthma (aOR = 1.7, 95% CI [1.1-2.4]), chronic obstructive pulmonary disease (aOR = 2.5, CI [1.5-4.0]), arthritis (aOR = 2.1, CI [1.4-3.0]), and cancer (aOR = 1.8, 95% CI [1.0-3.2]) among sexual minorities. Disparities in the prevalence of stroke, heart attack, coronary health disease, COPD, diabetes, obesity, arthritis, and cancer were found among LGBT populations. CONCLUSIONS:Sexual minorities have a higher prevalence of sleep deprivation as compared with their straight counterparts. Sleep deprivation varies by sexual identity and gender. Very short sleep duration is associated with some chronic health conditions among LGBT populations. Promotion of sleep health education and routine medical assessment of sleep disorders are critically needed for sexual minority adults.
    背景与目标: 目的:研究不同性别的成年少数群体的睡眠时间与健康结局之间的关联。
    方法:使用2014年行为危险因素监测系统的数据,我们比较了直食成年成年直觉成年成年人的睡眠时间(非常短:≤5小时;短:6小时;正常:7-8小时;每天:≥9小时)以及不同性别的少数群体。我们进一步研究了性少数群体的睡眠时间与10种慢性健康状况之间的关联。
    结果:在146,893名受访者中,有142,507名(96.2%)为顺性别,而有4,386名(3.8%)为女同性恋,男同性恋,双性恋和变性者(LGBT)。总体而言,LGBT受访者中有17.3%的人每天睡眠时间很短,而顺性别的受访者中有12.2%的人每天睡眠时间短(p <0.0001)。在LGBT人群中,不同组别的极短睡眠发生率差异显着,从跨性别女性到男性的13.2%,到跨性别性别不合格的成年人的35.5%。睡眠时间短还与中风(aOR = 4.1,95%CI [2.2-7.6]),心脏病发作(aOR = 3.0,CI [1.6-5.8]),冠心病(aOR = 3.1, 95%CI [1.5-6.2]),哮喘(aOR = 1.7、95%CI [1.1-2.4]),慢性阻塞性肺疾病(aOR = 2.5,CI [1.5-4.0]),关节炎(aOR = 2.1,CI [1.4-3.0])和性少数人群中的癌症(aOR = 1.8,95%CI [1.0-3.2])。在LGBT人群中发现中风,心脏病发作,冠心病,COPD,糖尿病,肥胖症,关节炎和癌症的患病率存在​​差异。
    结论:与异性恋人群相比,性少数人群的睡眠剥夺患病率更高。睡眠剥夺因性别和性别而异。极短的睡眠时间与LGBT人群中的某些慢性健康状况有关。性少数成年人迫切需要促进睡眠健康教育和睡眠障碍的常规医学评估。
  • 【肉毒杆菌毒素在宫颈和颌面部疾病中的治疗用途:循证审查。】 复制标题 收藏 收藏
    DOI:10.1016/j.tripleo.2007.02.004 复制DOI
    作者列表:Ihde SK,Konstantinovic VS
    BACKGROUND & AIMS: INTRODUCTION:The role of botulinum toxin as a therapeutic agent for several conditions is expanding. We sought to determine if botulinum toxin is safe and effective in treating patients with cervical dystonia and maxillofacial conditions. Our purpose was to establish a safety and efficacy profile to determine whether or not this treatment may be used prophylactically in patients undergoing dental implant therapy. METHODS:We performed a systematic search of the literature to identify randomized clinical trials evaluating patients treated with botulinum toxin as an adjunct to dental implant therapy, maxillofacial conditions including temporomandibular disorders (TMD), and cervical dystonia. RESULTS:Four randomized controlled trials (RCTs) met our search criteria in the area of cervical dystonia and chronic facial pain. No RCTs were identified evaluating dental implant therapy. Patients with cervical dystonia exhibited significant improvements in baseline functional, pain, and global assessments compared to placebo. Adverse events were mild and transient with numbers needed to harm (NNH) ranging from 12 to 17. Patients with chronic facial pain improved significantly from baseline in terms of pain compared to placebo. Rates of adverse events were less than 1%. CONCLUSION:Botulinum toxin appears relatively safe and effective in treating cervical dystonia and chronic facial pain associated with masticatory hyperactivity. No literature exists evaluating its use in dental implantology. Randomized clinical trials are warranted to determine its safety and efficacy in dental implantology and other maxillofacial conditions such as bruxism.
    背景与目标: 简介:肉毒杆菌毒素在多种情况下作为治疗剂的作用正在扩大。我们试图确定肉毒杆菌毒素在治疗患有颈肌张力障碍和颌面部疾病的患者中是否安全有效。我们的目的是建立安全性和有效性概况,以确定在接受牙种植体治疗的患者中是否可以预防性使用该治疗方法。
    方法:我们进行了系统的文献检索,以鉴定评估用肉毒杆菌毒素作为牙科植入物治疗,颌面部疾病(包括颞下颌疾病(TMD)和颈肌张力障碍)的辅助治疗的患者的随机临床试验。
    结果:四项随机对照试验(RCT)在宫颈肌张力障碍和慢性面部疼痛方面符合我们的搜索标准。未鉴定出评估牙种植体治疗的RCT。与安慰剂相比,宫颈肌张力障碍患者在基线功能,疼痛和整体评估方面表现出显着改善。不良事件是轻度和短暂的,需要伤害的数字(NNH)在12到17之间。与安慰剂相比,慢性面部疼痛患者在疼痛方面较基线有了显着改善。不良事件的发生率小于1%。
    结论:肉毒杆菌毒素在治疗颈肌张力障碍和咀嚼亢进引起的慢性面部疼痛方面似乎相对安全有效。没有文献评估其在牙种植学中的用途。必须进行随机临床试验来确定其在牙种植术和其他颌面疾病(例如磨牙症)中的安全性和有效性。
  • 【症状发生率,严重程度和姑息治疗需求评估使用姑息结果量表:一项针对帕金森氏病和相关神经系统疾病患者的横断面研究。】 复制标题 收藏 收藏
    DOI:10.1177/0269216312465783 复制DOI
    作者列表:Saleem TZ,Higginson IJ,Chaudhuri KR,Martin A,Burman R,Leigh PN
    BACKGROUND & AIMS: BACKGROUND:Palliative care is rarely being offered to patients with Parkinson's disease. AIM:To assess symptom prevalence, severity and palliative care needs in advanced stages of Parkinsonism. DESIGN:A cross-sectional survey using a palliative care assessment tool, the Palliative Outcome Scale was administered to patients. SETTING/PARTICIPANTS:Eight-two patients with a diagnosis of idiopathic Parkinson's disease, multiple systems atrophy or progressive supranuclear palsy were included in the study. RESULTS:Their mean age and disease stages 3-5 Hoehn and Yahr were 67 years and 4.1, respectively. Patients reported a mean of 10.7 (standard deviation = 3.9) physical symptoms. Over 80% had pain, fatigue, day time somnolence and problems with mobility. Other symptoms in 50%-80% included constipation, loss of bladder control, swallowing difficulties, drooling, breathlessness and sleep problems. Symptoms rated as causing severe problems were pain, fatigue, constipation and drooling. Assessment of mood revealed 70% of the patients felt anxiety and 60% had felt depressed. Eight-five per cent felt their families were anxious or worried about them. Thirty-eight per cent would have liked more information and 42% had practical problems that still needed to be addressed. There was a positive correlation between number of symptoms and disease severity (r = 0.39, p = 0.01). The total mean Palliative Outcome Scale score was 13.6 (standard deviation = 6.1), suggesting moderate palliative care needs. CONCLUSION:This is the first study to describe the care needs of people with Parkinson's disease using the Palliative Outcome Scale tool. The burden of symptoms and concerns was high in advanced stages of disease. It might be appropriate that people severely affected by these conditions should be considered for referral to specialist palliative care services.
    背景与目标: 背景:帕金森氏病患者很少接受姑息治疗。
    目的:评估帕金森病晚期患者的症状患病率,严重程度和姑息治疗需求。
    设计:使用姑息治疗评估工具进行横断面调查,对患者进行“姑息治疗结果量表”。
    设置/对象:本研究包括八十二名诊断为特发性帕金森氏病,多系统萎缩或进行性核上性麻痹的患者。
    结果:他们的平均年龄和疾病阶段3-5 Hoehn和Yahr分别为67岁和4.1。患者报告的平均身体症状为10.7(标准差= 3.9)。超过80%的人有疼痛,疲劳,白天嗜睡和行动不便的问题。 50%-80%的其他症状包括便秘,失去膀胱控制,吞咽困难,流口水,呼吸困难和睡眠问题。被认为造成严重问题的症状是疼痛,疲劳,便秘和流口水。情绪评估显示70%的患者感到焦虑,60%的患者感到沮丧。百分之八十五的人认为他们的家人感到焦虑或担心。 38%的人希望获得更多信息,而42%的人有实际问题需要解决。症状数量与疾病严重程度之间呈正相关(r = 0.39,p = 0.01)。总体平均姑息治疗量表评分为13.6(标准差= 6.1),表明需要中等程度的姑息治疗。
    结论:这是第一项使用姑息结果量表工具描述帕金森氏病患者护理需求的研究。在疾病的晚期阶段,症状和忧虑的负担很高。应当考虑将受这些疾病严重影响的人转介到专门的姑息治疗服务。
  • 【在巴西Paracoccidioides Brasiliensis适应不同环境条件的过程中涉及90 kDa热激蛋白。】 复制标题 收藏 收藏
    DOI:10.1016/j.fgb.2012.11.005 复制DOI
    作者列表:Tamayo D,Muñoz JF,Torres I,Almeida AJ,Restrepo A,McEwen JG,Hernández O
    BACKGROUND & AIMS: :HSP90 is a molecular chaperone that participates in folding, stabilization, activation, and assembly of several proteins, all of which are key regulators in cell signaling. In dimorphic pathogenic fungi such as Paracoccidioides brasiliensis, the adaptation to a higher temperature, acid pH and oxidative stress, is an essential event for fungal survival and also for the establishing of the infectious process. To further understand the role of this protein, we used antisense RNA technology to generate a P. brasiliensis isolate with reduced PbHSP90 gene expression (PbHSP90-aRNA). Reduced expression of HSP90 decreased yeast cell viability during batch culture growth and increased susceptibility to acid pH environments and imposed oxidative stress. Also, PbHSP90-aRNA yeast cells presented reduced viability upon interaction with macrophages. The findings presented here suggest a protective role for HSP90 during adaptation to hostile environments, one that promotes survival of the fungus during host-pathogen interactions.
    背景与目标: :HSP90是一种分子伴侣,参与多种蛋白质的折叠,稳定,激活和组装,所有这些都是细胞信号传导中的关键调控因子。在双态致病性真菌(如巴西副球菌)中,适应更高的温度,酸性pH和氧化应激,是真菌存活和建立感染过程的重要事件。为了进一步了解该蛋白的作用,我们使用了反义RNA技术来生成具有降低的PbHSP90基因表达的巴西假单胞菌分离物(PbHSP90-aRNA)。 HSP90的表达降低会降低分批培养物生长过程中酵母细胞的活力,并增加对酸性pH环境的敏感性和施加的氧化应激。同样,PbHSP90-aRNA酵母细胞与巨噬细胞相互作用后,活力降低。此处提出的发现表明,HSP90在适应敌对环境期间具有保护作用,可在宿主与病原体相互作用期间促进真菌的存活。
  • 【鞭毛衣藻的模式形成与外部条件的关系。】 复制标题 收藏 收藏
    DOI:10.1016/S0932-4739(11)80005-2 复制DOI
    作者列表:Yamamoto Y,Okayama T,Sato K,Takaoki T
    BACKGROUND & AIMS: :In Chlamydomonas reinhardtii, the entire process of pattern formation was described, and the relation of pattern formation to external conditions was investigated. The typical pattern was a dot-like structure that formed during a series of changes in cellular behavior, and reappeared immediately and repeatedly after perturbation by mild agitation. Of the external conditions, cell density, depth of the cell suspension, and the vessel's wall are discussed mainly. Especially the vessel's wall may decide the position and whole shape of the pattern formation.
    背景与目标: :在莱茵衣藻中,描述了图案形成的整个过程,并研究了图案形成与外部条件的关系。典型的模式是在一系列细胞行为变化期间形成的点状结构,并在受到轻微搅动扰动后立即并反复出现。在外部条件中,主要讨论细胞密度,细胞悬浮液深度和血管壁。特别是容器壁可以决定图案形成的位置和整体形状。
  • 【退伍军人事务部对患有黄斑疾病的退伍军人进行盲人康复的经济评估。】 复制标题 收藏 收藏
    DOI:10.1080/09286580802027836 复制DOI
    作者列表:Stroupe KT,Stelmack JA,Tang XC,Reda DJ,Moran D,Rinne S,Mancil R,Wei Y,Cummings R,Mancil G,Ellis N,Massof RW
    BACKGROUND & AIMS: PURPOSE:The Department of Veterans Affairs (VA) Low Vision Intervention Trial (LOVIT) developed an outpatient low-vision programme for patients with macular diseases providing low-vision rehabilitation comparable to VA inpatient blind rehabilitation centres (BRCs). This programme targets veterans who do not need or chose not to participate in a comprehensive inpatient blind rehabilitation programme. We examined costs and consequences using veterans in LOVIT and comparable veterans in an inpatient BRC. METHODS:We compared costs and consequences between treatment patients who participated in LOVIT, a two-site randomized clinical trial, and a sample of comparable patients who received treatment at a VA inpatient BRC. We measured consequences as the change in functional visual ability from baseline to follow-up (LOVIT: 4 months after randomization; BRC: 3 months after discharge) using the VA Low Vision Visual Functioning Questionnaire (VA LV VFQ-48). RESULTS:There were 55 LOVIT and 121 BRC patients for our analyses. Average costs were $38,627.3 higher for BRC patients ($5,054.4 +/- $404.7 SD for LOVIT vs. $43,681.7 +/- $8,853.6 SD for BRC, p < 0.0001). Thus, the BRC cost $38,627.3 per patient more than the LOVIT programme (95% CI: $17,414 to $273,482). There was a greater improvement in overall visual ability, mobility, and visual motor skill scores for BRC patients; however, there was no significant difference in improvement in reading ability or visual information processing scores. CONCLUSIONS:As VA increases outpatient blind rehabilitation services, LOVIT provides a model for expanding outpatient low-vision rehabilitation services for veterans at substantially lower costs than current inpatient BRC services.
    背景与目标: 目的:退伍军人事务部(VA)低视力干预试验(LOVIT)为黄斑疾病患者制定了门诊低视力计划,该计划可提供与VA住院盲人康复中心(BRC)相当的低视力康复服务。该计划针对不需要或选择不参加全面的住院盲人康复计划的退伍军人。我们使用LOVIT中的退伍军人和住院BRC中可比的退伍军人检查了成本和后果。
    方法:我们比较了参加LOVIT的治疗患者,一项两点随机临床试验和在VA住院BRC接受治疗的可比较患者的样本之间的成本和后果。我们使用VA低视力视觉功能问卷(VA LV VFQ-48),测量了从基线到随访(LOVIT:随机分组后4个月; BRC:出院后3个月)的功能性视觉能力变化的后果。
    结果:本研究共纳入55例LOVIT患者和121例BRC患者。 BRC患者的平均费用高出38,627.3美元(LOVIT为$ 5,054.4 /-$ 404.7 SD,而BRC为$ 43,681.7 /-$ 8,853.6 SD,p <0.0001)。因此,每位患者的BRC费用比LOVIT计划高出38,627.3美元(95%CI:17,414美元至273,482美元)。 BRC患者的整体视觉能力,活动能力和视觉运动技能得分有了更大的提高;但是,阅读能力或视觉信息处理得分的提高没有显着差异。
    结论:随着VA增加门诊盲人康复服务,LOVIT提供了一种模式,可为退伍军人扩展门诊低视力康复服务,其成本远低于目前的住院BRC服务。
  • 【希腊对达比加群酯在房颤管理中的经济评价。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Andrikopoulos GK,Fragoulakis V,Maniadakis N
    BACKGROUND & AIMS: INTRODUCTION:The objective of the present study was to evaluate, from an economic perspective, dabigatran etexilate in comparison to existing pharmaceutical therapeutic options available for the protection of moderate-to-high risk patients with non-valvular atrial fibrillation from cardioembolic risk. METHODS:An existing Markov model was adapted to the Greek setting to reflect the natural course of the disease and the management of patients with different therapies. The model predicts health and economic outcomes and the implications for the social security system during the course of a patient's lifetime. The data for the population of the model were derived from the international literature and local economic databases. RESULTS:The incremental cost per quality-adjusted life year (QALY) of dabigatran 150 mg twice daily relative to the other therapies varied from €5547 to €11,762 and that of dabigatran 110 mg twice daily from €7398 to €16,437. The incremental cost per QALY of dabigatran 150 mg relative to aspirin, the least costly option, was €11,762 and relative to warfarin and acenocoumarol, the local standards of care, it was €11,400 and €11,224 respectively, well below the local thresholds of acceptance. CONCLUSION:Dabigatran etexilate may represent a cost-effective option for the prevention of thromboembolic events in AF patients at moderate-to-high risk of stroke or systemic embolism.
    背景与目标: 简介:本研究的目的是从经济角度评估达比加群酯与现有药物治疗方案的比较,以保护中至高危非瓣膜性心房颤动患者免受心脏栓塞风险。
    方法:现有的马尔可夫模型适应希腊环境,以反映疾病的自然病程和采用不同疗法的患者的治疗。该模型可预测患者一生中的健康和经济状况以及对社会保障系统的影响。该模型的人口数据来自国际文献和当地经济数据库。
    结果:相对于其他疗法,达比加群150 mg每天两次的每质量调整生命年(QALY)的增量成本从5547欧元到11762欧元不等,达比加群110 mg每天两次的费用从7398欧元到16437欧元。相对于阿司匹林(成本最低的选择),达比加群150 mg的每QALY增量成本为11,762欧元,而相对于华法林和醋香豆酚(当地护理标准),分别为11,400欧元和11,224欧元,远低于当地的接受阈值。
    结论:达比加群酯可能是预防中风或全身性栓塞风险的中高风险房颤患者血栓栓塞事件的一种经济有效的选择。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录