摘要
Primary Health Care (PHC) constitutes the basis of the Chilean public health system. For more than 30 years, Primary Health Care (PHC) has been internationally recognized as one of the key components of an effective health system, since it is considered a development strategy to achieve better levels of health, which is why WHO strongly encourages countries to strengthen the primary level of care. However, despite the relevance of PHC and the evidence in its favor, there are important barriers to the implementation of the family medicine model in the health system in Chile. Therefore, it is important to know in detail the benefits of a strong PHC and the difficulties that plague the public care system for its development.
La Atención Primaria de Salud (APS) constituye la base del sistema público de salud chileno. Desde hace más de 30 años la Atención Primaria de Salud (APS) es reconocida internacionalmente como uno de los componentes claves de un sistema de salud efectivo, puesto que se considera una estrategia de desarrollo para alcanzar mejores niveles de salud, razón por la cual la OMS promueve enfáticamente que los países fortalezcan el nivel primario de atención. Sin embargo, a pesar de la relevancia de la APS y la evidencia a favor, existen barreras importantes para la implementación del modelo de medicina familiar en el sistema de salud en Chile. Por lo tanto, es importante conocer a detalle los beneficios de una APS fuerte y las dificultades que aquejan el sistema público de atención para el desarrollo de ésta.
Subject(s)
Humans , Primary Health Care/trends , Community Health Centers , Comprehensive Health Care , Physicians/statistics & numerical data , Health Systems , Chile , Family Health , Health Resources/supply & distribution摘要
BACKGROUND:The majority of studies on developmental dysplasia of the hip focus on hip malformations,but there are few reports on the effects of acetabular dysplasia on the spine. OBJECTIVE:To investigate the compensation of spinopelvic parameters in coronal and sagittal views in patients with developmental dysplasia of the hip,and to explore the correlation between acetabular development and spinopelvic parameters. METHODS:A total of 101 patients with developmental dysplasia of the hip admitted to the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2018 to June 2022 were selected as the trial group,and 114 healthy subjects were selected as the control group during the same period.The spinopelvic parameters of the subjects were measured through the full-length X-ray films of the coronal and sagittal spines:lumbar lordosis,anterior pelvic tilt,thoracolumbar kyphosis,Cobb angle,and the distance between the C7 plumb line and the center sacral vertical line,sacral slope,pelvic incidence,and thoracic kyphosis.The differences in spinopelvic parameters were compared between the two groups.In addition,the differences in spinopelvic parameters in patients with unilateral,bilateral and different Crowe classifications of developmental dysplasia of the hip were compared.Pearson correlation analysis was used to explore the correlation between Sharp angle and spinopelvic parameters. RESULTS AND CONCLUSION:(1)In the sagittal view,the lumbar lordosis in the trial group was significantly lower than that in the control group(P<0.05).The pelvic tilt and kyphosis angle of the thoracolumbar segment in the trial group were significantly greater than those in the control group(P<0.05).In the coronary position,the Cobb angle and the distance between the C7 plumb line and center sacral vertical line in the trial group were significantly greater than those in the control group(P<0.05).There was no significant difference in the remaining spinopelvic parameters between the two groups(P>0.05).(2)The lumbar lordosis of patients with bilateral developmental dysplasia of the hip was significantly lower than that of patients with unilateral developmental dysplasia of the hip(P<0.05).The pelvic tilt,thoracolumbar kyphosis,Cobb angle and the distance between the C7 plumb line and center sacral vertical line in bilateral developmental dysplasia of the hip patients were significantly greater than those in unilateral developmental dysplasia of the hip patients(P<0.05).(3)The lumbar lordosis decreased with the increase of Crowe classification severity(P<0.05).The pelvic tilt increased with the severity of the Crowe classification(P<0.05).(4)Pearson correlation analysis showed that Sharp angle was negatively correlated with lumbar lordosis(P<0.05),while Sharp angle was positively correlated with anterior pelvic tilt,Cobb angle,C7 plumb line and center sacral vertical line(P<0.05).(5)It is concluded that the pelvic tilt,thoracolumbar kyphosis,Cobb angle and the distance between the C7 plumb line and center sacral vertical line increase,while lumbar lordosis decreases in developmental dysplasia of the hip patients.The degree of acetabular dysplasia was significantly correlated with lumbar lordosis,pelvic tilt,Cobb angle,C7 plumb line and center sacral vertical line.
摘要
Objective:Based on the relevance risk analysis of medical equipment,to formulate process management strategies to improve the clinical operation efficiency of medical equipment.Methods:The risk matrix was evaluated from the perspectives of subject,quality,environment,system and diagnosis and treatment perspective,the comprehensive evaluation model of relevance risk was established,and multiple process management countermeasures were formulated.400 sets of medical equipment in clinical use in Shanghai Eighth People's Hospital from April 2021 to March 2022 were selected and divided into the control group and the observation group by the digital table method,with 200 sets in each group.The control group adopted the individualized risk analysis method for process management,and the observation group adopted the relevance risk analysis method for process management.The risk level and operation benefits of the two groups of medical equipment were compared and analyzed.Results:The high risk rates of medical imaging diagnostic and auxiliary equipment,surgical treatment equipment,life support and first aid equipment,extracorporeal circulation and blood processing equipment,health monitoring and rehabilitation equipment in the observation group were 17.39%(4/23),14.58%(7/28),12.24%(6/49),5.55%(1/18)and5.06%(5/62),respectively,which were lower than those in the control group,the difference was statistically significant(x2=4.132,4.009,6.275,4.833,4.859,P<0.05).The scores of cost benefit,social benefit,diagnosis and treatment benefit and development benefit of medical equipment in the observation group were(91.37±6.15)points,(92.78±3.80)points,(95.25±2.09)points and(90.51±3.82)points,respectively,which were higher than those in the control group,the difference was statistically significant(t=2.392,3.877,4.841,2.504,P<0.05).Conclusion:The relevance risk analysis method can reduce the probability and hazard degree of medical equipment safety risks,improve the clinical operation efficiency of medical equipment,and the process management strategy is in line with the actual needs of the medical equipment lifecycle management.
摘要
INTRODUCCIÓN: El currículo en la educación de enfermería debe estar alineado con las necesidades sociales y las políticas de educación superior y salud, siendo necesaria la revisión permanente de sus elementos curriculares a fin de lograr una mayor pertinencia y adecuación con los procesos académicos sustantivos: investigación, docencia y vinculación con el medio. OBJETIVO: Analizar el nivel de pertinencia del currículo de la carrera de enfermería de la Universidad Técnica del Norte, 2023. METODOLOGÍA: Estudio con enfoque cuantitativo de tipo no experimental con diseño descriptivo, analítico y de corte transversal. RESULTADOS: Existe una participación predominante de estudiantes mujeres en un 68% y el 93% de docentes mujeres quienes tienen una alta preparación académica, la mayoría se auto identifican como mestizos y un 18% son de otras etnias. Para el 54,2% de los participantes, el currículo de la carrera tiene un nivel medio de pertinencia, un significativo porcentaje 23,2% lo califica con una puntuación alta. Se considera la articulación del currículo-vinculación como el medio con la mayor fortaleza de la carrera. Otros elementos son considerados apropiados como equipamiento, planta física y recursos didácticos y existe coherencia de los planes de estudio y contenidos micro curriculares con las exigencias de las políticas y dinámicas del mercado laboral en el ámbito sanitario. CONCLUSIONES: Los porcentajes elevados de las diferentes tablas y el análisis realizado concluye que se requiere innovación en los procesos de enseñanza-aprendizaje que permitan adaptarse a las necesidades actuales del campo laboral y se destaca, además la importancia de una gestión académica que promueva un currículo pertinente, apropiado y dinámico que analice y mejore las necesidades sociales y de salud.
INTRODUCTION: The nursing education curriculum must be aligned with the social needs and policies of higher education and health, and the permanent review of its elements are necessary to achieve greater relevance and adequacy with respect to academic processes, research, teaching, and association with the community. OBJECTIVE: To analyze the relevance of the curriculum that prepares students for the nursing career at the Universidad Técnica del Norte, 2023. METHODOLOGY: Study using a non-experimental quantitative approach with descriptive, analytical, and cross-sectional design. RESULTS: There is a predominant participation of female students (68%) and female teachers (93%) who have high academic qualifications; the majority self-identify as mestizos and 18% with other ethnicities. For 54,2% of participants, the nursing career curriculum has an average level of relevance; a significant 23,2% rate it with a high score. The articulation of the curriculum linkage is considered the greatest strength of the career path, and the curricula and microcurricular contents are coherent with the policies and dynamics of the labor market in the health field. Other elements considered appropriate include equipment, physical plant and teaching resources. CONCLUSIONS: The high percentages seen in the different tables and the subsequent analysis conclude that innovation is required in the teaching-learning process to facilitate adaptation to the current needs of the labor market. Academic management is also important to promote a dynamic and relevant curriculum that meets social and health needs.
摘要
Objective. Within the context of evidence-based practice, this article exposes the reflection on the understanding and usefulness of the information provided by the research findings shared in reports and research publications, exposing differences based on the interpretation of statistical significance and clinical significance. Content synthesis. Basic aspects of the meaning and use of the information reported by research on p value (statistical significance) and the value and usefulness of these results are analyzed and exemplified, contrasting the value for the practice of an additional judgment on clinical significance. In addition to establishing conceptual differences, the need is highlighted for nurses to have the competencies to differentiate and apply each of them according to the clinical contexts of their potential implementation. Conclusion. The real usefulness of research about interventions within the context of nursing care is given by its real application and reach for the practice and benefit for patients. For this to occur, nurses must interpret adequately the information provided by scientific publications and other research reports.
Objetivo. En el contexto de una práctica basada en evidencia, este artículo expone la reflexión sobre la comprensión y utilidad de la información que proveen los hallazgos de investigación reportados en informes y publicaciones de investigación, exponiendo las diferencias a partir de la interpretación de la significancia estadística y significancia clínica. Síntesis del contenido. Se analizan y ejemplifican aspectos básicos sobre el significado y uso de la información que reportan las investigaciones sobre valor p (significancia estadística) y el valor y utilidad de estos resultados contrastando el valor para la práctica de un juicio adicional sobre significancia clínica. Además de establecer diferencias conceptuales, se resalta la necesidad de que las enfermeras tengan las competencias para diferenciar y aplicar cada uno de ellos según los contextos clínicos de su potencial implementación. Conclusión. La real utilidad de la investigación sobre intervenciones en el contexto del cuidado de enfermería está dada por su real aplicación y alcance para la práctica y el beneficio para los pacientes. Para que ello ocurra, las enfermeras deben interpretar adecuadamente la información que proveen las publicaciones científicas y otros reportes de investigación.
Objetivo. No contexto de uma prática baseada em evidências, este artigo apresenta a reflexão sobre a compreensão e utilidade da informação fornecida pelos resultados da investigação relatados em relatórios de investigação e publicações, expondo as diferenças com base na interpretação da significância estatística e da significância clínica. Síntese de conteúdo. Aspectos básicos sobre o significado e uso das informações relatadas pelas pesquisas sobre valor p (significância estatística) e o valor e utilidade desses resultados são analisados e exemplificados, contrastando o valor para a prática de um julgamento adicional sobre significância clínica. Além de estabelecer diferenças conceituais, destaca-se a necessidade de o enfermeiro ter competências para diferenciar e aplicar cada uma delas de acordo com os contextos clínicos de seu potencial implementação. Conclusão. A real utilidade da investigação sobre intervenções no contexto dos cuidados de enfermagem é dada pela sua real aplicação e âmbito de prática e benefício para os pacientes. Para que isso ocorra, os enfermeiros devem interpretar adequadamente as informações fornecidas pelas publicações científicas e outros relatórios de pesquisa.
Subject(s)
Humans , Male , Female , Nursing Research , Data Interpretation, Statistical , Evidence-Based Practice , Clinical Relevance , Nursing, Practical摘要
The incidence of dry eye disease has increased manifold in the past few years with more patients presenting with these complaints to our clinics every day. In the more severe forms of disease, it is important to evaluate for any systemic association which could be driving the disease such as in Sjogren’s syndrome. Understanding the possible varied etiopathogenesis and knowing when to evaluate, form an important part of treating this condition effectively. In addition, it is sometimes confusing as to which investigations to order and how to prognosticate the disease in these situations. This article simplifies this into an algorithmic approach with insights from the ocular and systemic point of view
摘要
Este artigo apresenta os resultados de um estudo sobre a percepção que os usuários têm da relevância das fontes de informação utilizadas por eles para se elucidarem sobre a covid-19 no cenário brasileiro durante a pandemia dessa doença. Os dados coletados para o estudo foram obtidos mediante a aplicação de um questionário distribuído via e-mail, Facebook, Instagram e WhatsApp. Os resultados mostram atribuição de relevância predominante a fontes formais e institucionais, como a Organização Mundial de Saúde (OMS), artigos científicos, universidades, Agência Nacional de Vigilância Sanitária (Anvisa), hospitais e postos de saúde. Dentre as fontes consideradas menos relevantes destacam-se jornais e/ou revistas, o Ministério da Saúde (MS) brasileiro e canais de televisão. As redes sociais (Facebook, Instagram, YouTube, WhatsApp, Twitter etc.), os amigos e/ou colegas, os mecanismos de busca na Internet (Google, Yahoo, Bing etc.) e familiares também se destacam como fontes de informação menos relevantes
This paper presents the results of a study on the users' perception of information of the relevance of infor-mation sources used by them to elucidate about covid-19 in the Brazilian scenario during the pandemic of this disease. The data were collected with use of a questionnaire distributed by email, Facebook, Instagram and WhatsApp. The results demonstrated a predominant attribution of relevance to formal and institution-al information sources, such as the World Health Organization (WHO), scientific papers, universities, the Anvisa Agência Nacional de Vigilância Sanitária (the National Health Surveillance Agency), hospitals, and health centers. Among the sources considered less relevant were highlighted newspapers and/or mag-azines, the Brazilian Ministry of Health, and television channels. Social networks (Facebook, Instagram, YouTube, WhatsApp, Twitter, etc.), friends and/or colleagues, Internet search engines (Google, Yahoo, Bing, etc.) and family members also stand out as less relevant sources of information
Este artículo presenta los resultados de un estudio sobre la percepción que tienen los usuarios de la relevancia de las fuentes de información utilizadas por ellos para enterarse de la covid-19 en el escenario brasileño durante la pandemia de esta enfermedad. Los datos recolectados para el estudio se obtuvieron mediante la aplicación de una encuesta distribuida a través de correo electrónico, Facebook, Instagram y WhatsApp. Los resultados muestran una atribución de relevancia predominante a fuentes formales e institucionales, como la Organización Mundial de la Salud (OMS), artículos científicos, universidades, la Anvisa - Agência Nacional de Vigilância Sanitária (Agencia Nacional de Vigilancia Sanitaria), hospitales y centros de salud. Entre las fuentes consideradas menos relevantes están periódicos y/o revistas, el Ministerio de Salud brasileño y canales de televisión. También se destacan como fuentes de información menos relevantes las redes sociales (Facebook, Instagram, YouTube, WhatsApp, Twitter, etc.), los amigos y/o compañeros, los motores de búsqueda en la Internet (Google, Yahoo, Bing, etc.) y los familiares.
Subject(s)
Humans , Pandemics , Information Sources , Social Networking , Data Analysis , COVID-19摘要
@#Abstract: Objective To investigate the correlation between persistent and non-persistent HPV infection and vaginal microecology and cervical lesions, and to provide the basis for HPV prevention and treatment. Methods In this prospective study, 229 female patients with high-risk type (HR-HPV) were selected for cervical cytology and vaginal microecological examination in the gynecological outpatient department of Baise Maternal and Child Health Hospital from January 2018 to June 2021. The patients were followed up for 1 year to detect persistent HR-HPV infection. The relationship between HR-HPV persistent infection and vaginal microecology and cervical lesions was analyzed using the HPV-negative group as a control. Results Among 229 patients with HR-HPV, there were 109 patients with persistent HR-HPV infection and 120 patients with non-persistent HR-HPV infection in 1-year follow-up, and the incidence of persistent HR-HPV infection was 47.6%. In the HR-HPV persistent and non-persistent infection and HPV-negative groups, the bacterial vaginal incidence was 20.2%, 15.0% and 8.6%, respectively; vulvovaginal candidiasis was 19.3%, 13.3% and 7.9%, respectively; trichomoniasis vaginitis was 12.8%, 9.2% and 4.5%, respectively; mixed infection was 10.1%, 6.7% and 2.7%; H2O2 detection rate was 24.8%, 18.3% and 12.0%,the positive rate of pH value was 52.3%, 40.8% and 36.4%, and microecological normal detection rate was 22.9%, 32.7% and 40.2%, respectively. There were significant differences among the three groups (χ2=10.634, 10.522, 9.010, 9.374, 10.054, 8.268, P<0.01). In the HR-HPV persistent and non-persistent infection groups, the rates of atypical squamous cell detection were 12.8% and 10.0%, and 8.3% and 4.2% for low-grade squamous cell lesions, and 4.6% and 1.7% for high-grade squamous cell carcinoma, 2.8% and 0 for squamous cell carcinoma, respectively. There was no significant difference in the composition of atypical squamous cells between the two groups (χ2=4.358, P>0.05), there were significant differences in the composition of low-grade, high-grade and squamous cell carcinoma (χ2=11.472, 12.685, 11.378, P<0.01). Spearman rank correlation analysis showed that the presence or extent of HPV infection was positively correlated with bacterial vaginosis, vulvovaginal candidiasis, trichomonal vaginitis and mixed infection (P<0.05), positively correlated with H2O2, sialdase, leucocyte esterase,pH positive and positive for all four items (P<0.05), negatively correlated with microecology (P<0.01), positively correlated with low grade, high grade and squamous cell carcinoma (P<0.01), and not significantly correlated with atypical squamous cell carcinoma (P>0.05). Conclusion Persistent cervical HPV infection is an important factor of dysregulation in vaginal microecology and aggravates the degree of dysregulation in vaginal microecology, which is related to the development of cervical lesions.
摘要
Background@#The association between hepatitis C virus (HCV) infection and chronic kidney disease (CKD) still remains controversial. We aimed to investigate whether HCV really affects renal function, and to analyze the association between clinical effects of CHC and decreased kidney function (assessed by glomerular filtration rate (eGFR) level).@*Aim@#Study of renal dysfunction in chronic hepatitis C virus infection@*Materials and Methods@#An estimated 222 patients with HCV infection and 222 age- and sex-matched community-based control individuals without HCV were enrolled (1:1, case and control ratio) in this study between from June 2022 to March 2023. We used the modification of diet in renal diseases to calculate eGFR. This study was approved by the review board of the Ethics Subcommittee of Ach Medical University and followed the Declaration of Helsinki. All statistical analysis was performed with SPSS version 26.0 software (SPSS Inc., Chicago, IL, USA), and a P value < 0.05 was considered statistically significant. Continuous variebles were presented as mean ± standard deviation, while categorical data was represented as numbers and percentages. Independent t-tests were used to compare the differences in parametric variables. The Mann-Whitney U test was performed to compare the follow-up period. Pearson’s chi-squared and Fisher’s exact tests were used to compare categorical variables. Multivariate logistic regression was used to identify the risk factors associated with recurrence. @*Results@#The median age of the respondents was 40 (range 21-70). In the case group, the speed of hanging judgment was 105.3±24.5, and in the control group, it was 118.7±18.5, which was a statistically significant difference (p<0.05, p<0.05). It was observed that the rate of filtration of the renal is below 90 or the loss of renal function increases with age (47.50±9.3 vs 40.21±11.1; p<0.01). In order to reduce the effect of age, when evaluating the renal function of participants over 45 years of age in the case-control group, the HCV was 99.69 in the case group and 111.05 in the control group, although there was an age effect on the decline in HCV in both groups, but it decreased more in the HCV-infected group. When comparing two groups (<3.25, >3.25) with liver fibrosis degree above and below 3.25, the higher degree of fibrosis affects the decrease in the rate of hepatic filtration (112.92±19.8 vs 105.23±27.1; p<0.01). The proportion of cryoglobulinemia was high when renal dysfunction was beginning or when the GFR was below 90 (<90). Logistic regression analysis showed that cryoglobulinemia had the greatest influence on the decrease in glomerular filtration rate (OR 4.22, 95% CI 1.97-9.00, p<0.05). The relationship between age and the decline in hanging judgment speed was statistically significant and directly moderate (r=0.95, p=0.009). On the other hand, there is a statistical relationship between gender and the decrease in the speed of hanging judgment, with a probable and weak correlation (r=0.07, p=0.01).@*Conclusion@#Our study found that the patients with HCV infection are associated with a low eGFR compared with non-HCV–infected patients. This association is consistent in age, gender, cryoglobulinemia and liver fibrosis patients.
摘要
Objective:To investigate the current situation of body image and stigma of drug-resistant tuberculosis patients treated with Clofazimine, and analyze the correlation between them.Methods:A cross-sectional study was conducted using convenience sampling method to investigate 150 patients with drug-resistant tuberculosis treated with Clofazimine in tuberculosis ward of Chengdu Public Health Clinical Medical Center from October 2020 to October 2021. The general questionnaire, Body Image Scale (BIS) and Tuberculosis Related Stigma Scale were used to conduct a questionnaire survey.Results:A total of 130 questionnaires were effectively collected. The body image score of 130 patients with drug-resistant tuberculosis treated with Clofazimine was (20.51 ± 6.80) points; the score of stigma was (17.78 ± 6.92) points. There was a positive correlation between the total score of disease shame and the total score of body image ( r=0.544, P<0.05). Conclusions:Patients with drug-resistant tuberculosis treated with Clofazimine have body image disorder and stigma, and the two are positively correlated. Caregivers should carry out psychological assessment and intervention at an early stage to improve the patient′s mental health level.
摘要
Objective:To explore the correlation between nurses′ workplace adaptability, moral dilemma and resilience after suffering workplace violence in emergency department, in order to provide reference about improving the workplace adaptability and formulating intervention.Methods:A cross-section survey was conducted, we selected 248 nurses who had suffered workplace violence in the emergency department of five tertiary hospitals in Qingdao from January 2022 to January 2023 by convenient sampling method, and used self-designed general information questionnaire, moral dilemma scale, resilience evaluation scale for medical staff and nurses′ workplace adaptability scale to conduct a questionnaire survey on nurses who had suffered workplace violence, and found out the factors affecting their workplace adaptability.Results:The score of workplace adaptability of 248 nurses who had suffered workplace violence was (39.37 ± 12.77) points. Univariate analysis showed that education, length of emergency service, department or social part-time job, professional title, number of night shifts and sleep condition were the influencing factors of workplace fitness for emergency nurses ( t/ F values were -12.72 to 132.15, all P<0.05). The correlation analysis showed that the nurses′ workplace adaptability after workplace violence was negatively correlated with the scores and total scores of all dimensions of moral dilemma ( r values were -0.725 to -0.194, P<0.05), and positively correlated with the scores and total scores of all dimensions of resilience ( r values were 0.135 to 0.732, P<0.05). Multi-factor results showed that education background, department/social part-time job, working years, professional title, sleep status, moral dilemma and resilience were the influencing factors of nurses′ workplace adaptability after workplace violence ( t values were -9.25 to 15.25, P<0.05). Conclusions:Nurses with specialized education, emergency service for 1-3 years, no department/social part-time job, primary professional title, sleep disorder, higher degree of moral dilemma and low level of resilience have low occupational adaptability. Nursing managers should focus on such nurses and improve their occupational adaptability.
摘要
Objective:To investigate the value of a 5-point predictive score based on unenhanced CT combined with blood glucose detection for predicting short-term prognosis in patients with spontaneous cerebral hemorrhage.Methods:A total of 102 patients with spontaneous intracerebral hemorrhage who received treatment in Zhejiang Provincial People's Hospital from March 2020 to March 2022 were included in this study and analyzed retrospectively. Blood glucose level was measured and BAT score was used to evaluate hematoma enlargement. After 30 days, Glasgow Outcome Scale was used to evaluate the prognosis of patients. The relationships between blood glucose and BAT score, and between blood glucose and BAT score and prognosis were analyzed. The value of blood glucose and BAT score for predicting short-term prognosis was analyzed.Results:The Glasgow Outcome Scale results showed that among the 102 patients, 24 patients (23.53%) had poor prognosis. The BAT score and blood glucose level in patients with poor prognosis were (3.13 ± 0.68) points and (11.58 ± 2.30) mmol/L, respectively, which were significantly higher than (2.40 ± 0.59) points and (8.88 ± 1.71) mmol/L in patients with good prognosis ( t = 5.10, 5.30, both P < 0.05). Pearson correlation analysis showed that in patients with spontaneous intracerebral hemorrhage, blood glucose level was positively correlated with BAT score ( r = 0.43, P < 0.05). Spearman correlation analysis showed that in patients with spontaneous intracerebral hemorrhage, blood glucose level and BAT level were positively correlated with prognosis ( r = 0.42, 0.47, both P < 0.05). The receiver operating characteristic curve showed that the area under the curve plotted for BAT score combined with blood glucose level for predicting short-term prognosis was 0.874, which was significantly greater than the area under the curve plotted for BAT score alone for predicting short-term prognosis ( Z = 2.54, P < 0.05). Conclusion:A large proportion of patients with spontaneous intracerebral hemorrhage have a poor prognosis. The patients with a poor prognosis have higher blood glucose levels and BAT scores than those with good prognosis. Blood glucose and BAT score have a high value for predicting the prognosis of patients with spontaneous intracerebral hemorrhage.
摘要
Objective:To explore the changing characteristics of interpretive bias of senior high school students with different levels of autistic traits in ambiguous situations, and to investigate the consistency of interpretive bias across self/other relevant conditions.Methods:A survey of 1 080 senior high school students from a high school in Anhui province was conducted by using the autistic-spectrum quotient (AQ). According to the criteria of high scores and low scores of 27%, the subjects in the high autistic trait group ( n=266) and the low autistic trait group ( n=266) were selected.The ambiguous situation paradigm was used to measure the frequency of positive interpretation of ambiguous information by two groups of subjects under the conditions of self and others, SPSS 26.0 was used for descriptive statistics, and jamovi 2.2.3 was used for generalized linear mixed model analysis. Results:(1) The results of the between-group effects at the level of autistic traits indicated that the frequency of positive interpretations in the high autistic group was significantly lower than that in the low autistic group(54.5(11.8), 57(11.8) )( χ2=13.99, P<0.001). The results of the interaction between level of autistic traits and type of ambiguous situation indicated that in the positive ambiguous situation, the frequency of positive interpretations in the high autistic group was smaller than that in the low autistic group (33(4), 34(3)) ( P<0.001). There was no significant differences in the number of positive interpretations between high autistic group and low autistic group in negtive ambiguous situation( P>0.05). (2) The results of the main effects of the ambiguous situation types indicated that the frequency of positive interpretations in positive ambiguous situations was significantly higher than that in negative ambiguous situations(33(4), 23(9.25)) ( χ2=1 348.50, P<0.001). The results of the interaction between level of autistic traits and type of ambiguous situation indicated that the frequency of positive interpretations in positive ambiguous situations (33(4), 34(3)) in both high and low autistic groups was larger than that in negative ambiguous situations (22(10), 24(9)) ( P<0.001). (3) The main effects results for the self/other related conditions suggested that the frequency of positive interpretations of familiarity with others (19(4)) was significantly higher than that of self-related conditions (19(5)) and strangers (19(5)) ( χ2=9.51, P<0.01), and there was no significant difference between self-related conditions and strangers( P>0.05). The results of the interaction between ambiguous situation type and self/other related conditions suggested that in the positive ambiguous situation, the frequency of positive interpretations of familiarity with other people's conditions was greater than that of self-related conditions( P<0.01), and in the negative ambiguous situations, there was no significant difference in the frequency of positive interpretations related to different self/others( P>0.05). Conclusions:(1) High school students with high and low autistic traits are more inclined to show positive interpretations in the ambiguous situations, and it higher under the condition of positive ambiguous situations and acquaintances.(2) Compared with those with low autistic traits, individuals with high autistic traits tend to give less positive interpretations to ambiguous situations, but this difference is mainly manifested in positive ambiguous situations.(3) In the negative ambiguous situation, there is no significant difference in number of positive interpretations produced by senior high school students with high and low autistic traits, and they are stable across self and other related conditions.
摘要
Objective To explore the correlation between childhood trauma and plasma adiponectin levels in patients with depression.Methods A total of 121 patients with depression and 39 healthy controls(control group)were enrolled.Childhood trauma questionnaire(CTQ-SF)was used to assess the experience of childhood abuse and neglect,and the patients with depression were divided into trauma group(n=53)and non-trauma group(n=68)according to the CTQ-SF score.The 17-item Hamilton depression scale-17(HAMD17)and the Hamilton anxiety scale(HAMA)were used to evaluate the severity of depression and anxiety symptoms,respectively.Plasma adiponectin levels of subjects were measured by enzyme-linked immunosorbent assay.Results The plasma adiponectin level of trauma group[3.82(2.44,4.92)μg/mL]was significantly lower than that of non-trauma group[4.64(2.98,6.43)μg/mL,P=0.01]and the control group[6.29(4.54,7.51)μg/mL,P＜0.01].The plasma adiponectin level of non-trauma group was lower than that of the control group(P＜0.01).Correlation analysis showed that plasma adiponectin level in patients with depression was negatively correlated with childhood trauma(r=-0.34,P＜0.01).Multivariate linear regression analysis showed that plasma adiponectin level was negatively correlated with childhood trauma scores in patients with depression(β=-0.05,P＜0.01).Conclusions Patients with depression who have experienced childhood trauma have lower plasma levels of adiponectin,and childhood trauma may be associated with decreased plasma adiponectin levels in patients with depression.
摘要
BACKGROUND: Ethiopia has been implementing a health extension program (HEP) to respond to the high maternal and child mortality in rural communities. HEP has brought tremendous contributions to improved access and coverage of primary healthcare in the last 15 years. Despite its attributions, attention to HEP has declined in recent years due to several reasons. This study is designed to explore HEP's relevance to the current healthcare needs of the rural communities. METHODS: This study is a nested cross-sectional mixed method to the overall HEP's evaluation between March and May 2019. Descriptive statistics were used on qualitative and quantitative assessment. A literature review supplemented the assessment. A representative quantitative sample of 11,746 women, men, and young girls; a qualitative sample of 268 key informants from Kebele administrators, HEWs, program people in the health system and focus groups from community leaders, men and women from 185 Kebeles in 62 woredas were selected. A thematic approach was used for qualitative analysis. RESULTS: Rural communities and program managers asserted that HEP's service packages with the existing service delivery modalities were relevant. Eighty-two percent of men and women and 77% of young girls confirmed this relevance. Besides the existing packages, additional curative services for adults and children were recommended with emphasis on the pastoralist community. HEP's service uptake has declined as over 86% of targeted rural communities bypassed HPs due to unavailability of services and capacity problems of HEWs. CONCLUSION: The current HEP packages with the existing service delivery modalities are still relevant to the rural communities' health needs. However, on-going changes to address the evolving demands of the targeted rural communities are crucial
Subject(s)
Humans , Clinical Relevance , Health Services Needs and Demand , Primary Health Care , Health Services Coverage摘要
Uterine leiomyosarcomas are tumors with a heterogeneous genetic profiles that respond very poorly to cytotoxic chemotherapy with aggressive progression. We aimed to show the status of peroxiredoxin 6 as a biomarker in leiomyosarcoma progression.Study included 12 patients diagnosed with "leiomyosarcoma" and 13 patients diagnosed with "myoma" (as control) after histopathological examinations of clinical samples. Peroxiredoxin-6 gene expression and protein levels were evaluated on the tumor preparations (blocks) utilizing ELISA and PCR methods.Peroxiredoxin-6 protein was mainly localized in the cytoplasm of leiomyosarcoma cells, and the expression of peroxiredoxin-6 was significantly increased in cancerous tissues compared to normal myoma tissues (3.33±1.7 vs. 2.03±1.07fold change; P= 0.031). Peroxiredoxin-6 tissue protein levels were also significantly higher in leiomyosarcoma cases (100.54±66.86 vs. 183.72±64.54 pg/µg protein; P= 0.005). Our findings demonstrate that peroxiredoxin-6 plays a vital role in the emergence and development of leiomyosarcoma and that peroxiredoxin-6 level assessments can be used as a biomarker in guiding better prognosis andtreatment plans while managing leiomyosarcoma.
摘要
Background: The perceived relevance of a subject/area will decide how much the student will study that. Competency based Medical Curriculum helps students to understand the subject relevance due to its structured format. The feedback from students about subject relevance is needed as they are the primary stakeholders for learning. In this era of involving molecular biology and genetics in medical field, it is very difficult to determine how much to teach a basic subject like embryology. This questionnaire study was done to know the viewpoints of 3rd semester & 5th semester medical students about the relevance and necessity of embryology in medical education. Method: An anonymous questionnaire was sent to 3rd semester, CBME batch & 5th semester students, traditional or regular batch of Sree Balaji Medical College, Chrompet. The pre validated questionnaire contained questions regarding the perceived relevance & importance of embryology. Results: Students reported the relevance of embryology knowledge for learning other medical subjects & they more often acknowledged embryology as being of great importance for their professional careers. This perception has increased especially after introduction of Competency based Medical Curriculum. Overall, study results suggest that medical students have a positive attitude toward embryology undergraduate course. Conclusion: This evidence could be used as an additional motive for the development embryology courses, with special emphasis on practical application of knowledge in clinically-oriented setting.
摘要
The onset of depression is related to many factors such as biological, psychological and social environment, and more and more studies have shown that early life adversity is a risk factor for depression. Patients with depression who have early life adversity have different clinical characteristics, such as greater cognitive impairment and higher risk of suicide, which may be related to changes in cognitive patterns. In addition, early life adversity can cause endocrine, immune and nervous system specific changes in depressed patients. This article reviews the relationship and mechanism between various types of early life adverse and depression, explores the onset of depression and provides theory evidence for early intervention.
摘要
@#Objective We aimed to investigate the influences of blood plasma inflammatory factors,high-sensitive C-reactive protein (hs-CRP),interleukin 6(IL-6),tumor necrosis factor-α and CD4+T cell concentration difference in blood of patients with perforating cerebral artery infarction.Methods A retrospective analysis was made from 134 patients with perforating artery infarction treated in our hospital from March 2020 to March 2022.According to the disease process,the patients were divided into two groups:Patients with progressive perforating artery infarction (n=68) (experimental group) and patients with non progressive perforating artery infarction (n=66) (control group).The levels of plasma hs-CRP,IL-6,TNF-α and the concentration of CD4+T cells in blood were compared between the two groups,and the factors affecting the progression of perforator artery infarction were analyzed by multivariate logistic regression.In addition,the levels of plasma hs CRP,IL-6 and TNF in patients with progressive perforator artery infarction in different severity groups were measured.And the concentration of CD4+T cells in blood were compared to analyze the relationship between CD4+T cells and the progress of patients’ disease.Result Compared with the control group,the concentration of CD4+T cells in the blood of the experimental group was significantly higher (P<0.05).The difference of plasma hs CRP,IL-6 and TNF-α expression between the two groups was significantly increased (P<0.05).The concentrations of plasma hs CRP,IL-6,TNF-α and CD4+T cells in patients with different severity in the experimental group were significantly different (P<0.01).The expression of plasma hs CRP,IL-6,TNF-α and CD4+T cells increased with the increase of disease severity (P<0.05).Conclusion The concentrations of plasma hs-CRP,IL-6,TNF-α and CD4+T cells in patients with progressive perforator artery infarction were significantly increased，and the level were significantly increased with the progression of the disease,which was of great significance in predicting the occurrence,progression and progression of perforator artery infarction.
摘要
@#Objective To investigate the relationship between white matter lesions (WML) and cerebral microbleeds (CMBs) in patients with lacunar infarction (LI).Methods The clinical dataes from 129 patients with LI in our hospital were analyzed retrospectively.According to the severity of CMBs,the patients were divided into no bleeding group (n=20),mild group (n=60),moderate group (n=37) and severe group (n=12).The general data and laboratory results of patients in different groups were compared,the correlation between CMBs and white matter lesion scale (WMLs) was analyzed,the Logistic multivariate analysis was used to analyze the related factors of WML and CMBS in patients with LI.Results The age and the incidence of hypertension complication in patients with different CMBs were statistically significant (P<0.05).There were significant differences in serum HDL-C,LDL-C,hs-CRP,Hcy,CIMT levels and carotid plaque score in patients with different disease degrees of CMBs (P<0.05).Logistic regression analysis showed that age,hypertension,HDL-C,Hcy and CIMT were independent risk factors for the combined incidence of WML and CMBS in patients with LI (P<0.05).Conclusion The severity of WML in patients with LI is positively correlated with the degree of CMBs.The increase of age,history of hypertension,low-level HDL-C,high-level Hcy and CIMT are independent risk factors for the combined incidence of WML and CMBs in patients with LI.