A review of the literature: interventions to maximize capacity to consent and reduce anxiety of women with learning disabilities preparing for a cervical smear test.

Due to the complex nature of the cervical screening for women with learning disabilities, this literature review has several different strands. The aim of which is to give a general overview of the literature available about women with learning disabilities and cervical screening. Discussing key issues in relation to uptake, access and risk factors associated with cervical screening. The role of the learning disability nurse in supporting access to cervical screening services within primary care will be explored. The notion that anxiety and a woman's capacity to consent impacts on her accessing cervical screening services and ultimately undergoing a cervical smear test, will be examined. Relaxation techniques with regard to ascertaining which techniques are more effective when used with individuals with a learning disability will also be discussed.     

Isolation of a new chlamydial agent from infected domestic poultry coincided with cases of atypical pneumonia among slaughterhouse workers in France

Three cases of atypical pneumonia in individuals working at a poultry slaughterhouse prompted an epidemiological survey in 10 poultry farms that had supplied birds. Using a Chlamydiaceae-specific real-time PCR assay, chlamydial agents were detected in 14 of 25 investigated flocks. Rather unexpectedly, Chlamydophila psittaci was identified only in one of the positive flocks, whereas ArrayTube DNA microarray testing indicated the presence of a new, so far unclassified member of the genus Chlamydophila.For further characterization of the agent involved, positive cloacal swabs were used to inoculate embryonated chicken eggs and isolates were obtained from 6 different flocks. Sequencing of 16S rRNA genes revealed nearly identical sequences of all samples. Alignment with representative sequences of Chlamydiaceae showed the separate position of the present strains outside the currently recognized species of Chlamydophila, but clearly within this genus. In contrast, partial ompA gene sequences displayed considerable diversity among the isolates, which had already been observed in restriction enzyme analysis of ompA PCR products. These data suggest that each farm had been infected with a different strain of this new chlamydial agent, the zoonotic potential and the exact taxonomic status of which have yet to be defined.     

SARS-CoV-2及其他β-冠状病毒相关呼吸系统疾病治疗措施的安全性系统评价与Meta分析

目的评估指南推荐疗法治疗严重急性呼吸综合征冠状病毒2(SARS-CoV-2)和其他β冠状病毒相关呼吸道疾病的安全性。方法系统检索PubMed、Embase、Web of Science、Cochrane library、SinoMed、中国知网、万方数据库2003—2020年6月公开发表的关于β-冠状病毒治疗措施的随机对照试验(RCT)、类试验和队列研究。双人独立筛选文献、提取资料,并对符合入选标准的文献采用Cochrane偏倚评价工具进行质量评价后,使用Stata 14.0版软件进行Meta分析。结果最终纳入59项研究,共计9598例。其中49项研究关于SARS-CoV-2,包括27项RCT,19项队列和3项类试验,9项研究关于SARS-CoV,1项队列关于中东呼吸综合征冠状病毒(MERS-CoV)。所有研究中显著性结果如下:在SARS-CoV-2患者中,两项关于洛匹那韦/利托那韦的队列和一项关于大剂量羟氯喹或氯喹的RCT比标准治疗有更多的整体不良反应事件发生[RR=2.68,95%CI(1.48,4.85),I²=34.3%,采用建议分级评估、开发和评价准则(GRADE)评级为:低;RR=3.43,95%CI(1.55,7.58),GRADE评级:中]。而在一项RCT和一项非随机对照试验中,应用洛匹那韦/利托那韦和皮质类固醇激素相比标准治疗发生急性呼吸窘迫综合征的发生率更低[RR=0.46,95%CI(0.25,0.86),GRADE评级:低;RR=0.65,95%CI(0.44,0.98),GRADE评级:极低]。两项应用瑞德昔韦治疗10 d的RCT[RR=0.94,95%CI(0.80,1.11),I²=28.8%,GRADE评级:中]和11项应用中药治疗的RCT[RR=0.77,95%CI(0.53,1.10),I²=0.0%,GRADE评级:低]的安全性与标准治疗相比差异无统计学意义。在SARS-CoV患者中,6项应用中药治疗的RCT相比标准治疗的总体不良反应发生率更低[RR=0.38,95%CI(0.21,0.71),I²=0.0%,GRADE评级:低]。结论洛匹那韦/利托那韦和大剂量羟基氯喹或氯喹治疗SARS-CoV-2的总体不良反应发生率更高,而瑞德西韦和中药相对安全。     

Veterinary Acupuncture—The Ancient Art of Healing

Acupuncture is the placing of needles into the body to obtain a painkilling and/or therapeutic effect. It is based on the fact that stimulating the skin has an effect on the internal organs and on other parts of the body, a relatively simple reflex which has largely been ignored in Western medicine. However, every mother carries out ‘acupressure’ every time her child falls over and bangs a knee. Her immediate reaction is to ‘rub it better’. Acupressure is pressure applied to an acupuncture point with a painkilling effect. Here, Trixie Williams aims to dispel some myths surrounding this ancient art.