ABSTRACT
Background and purpose:Currently, subjective questionaire is the most frequently used methods to evaluate swallowing dysfunctions after radiotherapy in nasopharyngeal carcinoma patients, while lacking of effective objective examinations. This study aimed to explore effective methods to evaluate swallowing dysfunctions after radiotherapy in nasopharyngeal carcinoma patients, and gain knowledge of the incidence and severity of swallowing dysfunctions. Methods: From Oct. 2013 to Dec. 2013, 128 consecutive outpatients with previously treated nasopharyngeal carcinoma received esophageal barium lfuoroscopy examination at there regularly follow-ups to evaluate swallowing function. Among these patients, 89 were primary treated with intensity modulated radiation therapy (IMRT) and 39 with conventional radiotherapy (CRT). In this study, each patient received esophageal barium lfuoroscopy examination for 3 times with thin, thick and pasty barium and were dynamically observed using X-ray fluoroscopy from front and lateral direction. Swallowing dysfunctions were defined as follows:①The bolus could not be swallowed and blocked in the mouth;②The dilute barium diverted to the glottis or trachea;③Residual barium delayed in the pyriform sinus and vallecula;④The movement of the hyoid bone or epiglottis were restricted;⑤Bolus prolong through the pharynx;⑥Barium slowed down when went though the esophageal entrance. Results:Of the 128 patients, incidence of dysphagia was 60.2%for the entire cohort, 52.8%for IMRT group and 76.9%for CRT group. Incidence of dysphagia for IMRT group was signiifcantly lower than CRT group (P=0.018). Dysphagia incidence within 1 year, 1 to 2 years and more than 2 years after RT were 63.1%, 33.3%and 69.0%, respectively (P=0.019). Conclusion:There was a high incidence of swallowing dysfunction for the nasopharyngeal carcinoma patients treated with radiotherapy and dysphagia incidence decreased when treated with IMRT. Esophageal barium lfuoroscopy examination is objective method to evaluate the incidence and severity of the swallowing dysfunction.
ABSTRACT
<p><b>BACKGROUND</b>The risk of HIV sexual transmission is much higher among people unaware of their HIV status than among those aware. Only a few studies have indicated that the incidence of unsafe sex can be reduced when people know their HIV status. This study was to investigate this effect in China.</p><p><b>METHODS</b>A cohort study consisting of two surveys was conducted at two different times among a group of people living with HIV/AIDS, whose status was newly diagnosed with HIV via sexual contact, in Shanghai, Chongqing, and Kunming. The first survey was conducted among 823 people tested positive for HIV before notifying them of the HIV status. The second survey was conducted among 650 HIV-positive people at six months following the first survey (after notification of HIV status). The scope of survey covered unsafe sex practices, number of unsafe sexual partners, and frequency of unsafe sexual behaviors over the prior six months. Unsafe sex is defined as unprotected anal or vaginal sex with partners who are HIV positive or whose HIV status is unknown.</p><p><b>RESULTS</b>The proportion of unsafe sex was reduced by about 85% after HIV status notification. The risk of HIV sexual transmission was 15 times higher among persons unaware of their HIV status than among those aware. Approximately 95% of new sexually transmitted HIV infections stemmed from 56% of the infected persons unaware of their HIV status in China.</p><p><b>CONCLUSION</b>Timely HIV status notification has the potential to significantly reduce unsafe sex among HIV-infected persons and reduce the risk for HIV transmission via unsafe sex.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , China , Cohort Studies , HIV Infections , Epidemiology , Sexually Transmitted Diseases , Unsafe SexABSTRACT
Objective To evaluate the use of isoptin in kidney transplants recipients. Methods The graft acute rejection rate,the cyclosporin A daily dose and its trough level and toxicity,the blood pressure and cardiovascular complications,the serum creatinine and blood sugar were studied in cadaveric kidney transplant recipients both with and without the additional use of isoptin. Results With the additional use of isoptin in 44 cadaveric kidney transplant recipients,the acute rejection rate has not increased.After using isoptin for 2 weeks,CsA blood level has been increased 25.5% whereas the CsA dose been cut down 32.6 %.So,drug expense dropped about 30.0% and CsA toxicity (hand tremble,insomnia) was slightly decreased. Conclusions Isoptin does not inecease the graft acute rejection rate yet makes the CsA dose and its toxicity less.