Administration and monitoring of clofazimine for NTM infections in children with and without cystic fibrosis

Few studies have evaluated clofazimine (CLOF) drug monitoring and safety in children. We treated 10 children, 8 with CF, for NTM infection with multiple antimicrobials, including CLOF. All had serial blood CLOF concentrations measured and were followed for adverse events. Despite CLOF dose escalation, most children with CF did not reach a target CLOF concentration. Our data suggest that children with CF may require earlier initiation of CLOF at higher doses than is currently recommended.     

Barriers to,and facilitators of,access to cancer services and experiences of cancer care for adults with a physical disability: A mixed methods systematic review

BackgroundCancer services need to be inclusive and accessible to everybody, including people with disabilities. However, there is evidence suggesting that people with disabilities experience poorer access to cancer services, compared to people without disabilities.ObjectivesTo investigate the barriers and facilitators of access to cancer services for people with physical disabilities and their experiences of cancer care.MethodsA mixed-method systematic review was conducted following the Evidence for Policy and Practice Information and Co-ordinating Centre approach. We used the Mixed Methods Appraisal Tool (MMAT -Version 11) to assess the quality of the included studies. We employed thematic synthesis to bring together data from across both qualitative and quantitative studies and we assessed the strength of synthesised findings using the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) approach.ResultsSeven quantitative studies and 10 qualitative studies (across 18 publications) were included. The findings highlighted a dearth of research on the experiences of men with disabilities. Furthermore, only one study explored experiences of cancer treatment, with all other studies focusing on cancer screening. Five synthesised findings were identified that reflected barriers and facilitators, highlighting both what makes access to services difficult and what are the strategies that could improve it.ConclusionsKnowing what works for people with disabilities can enable the delivery of appropriate services. The findings of this review suggest that the mere existence of services does not guarantee their usability. Services need to be relevant, flexible, and accessible, and offered in a respectful manner.     

维持性血液透析患者60 μg高剂量乙型肝炎疫苗免疫持久性及影响因素

目的 比较维持性血液透析患者0-1-6月20 μg和60 μg乙型肝炎（乙肝）疫苗全程接种后1年抗-HBs情况,探讨乙肝疫苗免疫持久性影响因素及交互作用。方法 在维持性血液透析患者0-1-6月20 μg和60 μg乙肝疫苗免疫接种随机对照试验研究基础上,以完成全程接种后1年随访的患者为研究对象,定量检测其抗-HBs,采用χ²检验、t检验、非条件logistic回归和交互作用进行统计分析。结果 全程接种后1年时,20 μg组和60 μg组各有125例和124例完成抗-HBs检测,60 μg组抗-HBs阳性率（77.42%,96/124）明显高于20 μg组（65.60%,82/125）（P<0.05）。控制混杂因素后,60 μg组抗-HBs阳性的概率是20 μg组的1.925倍（95% CI：1.068~3.468）;透析年限≥ 5年（OR=0.523,95% CI：0.293~0.935）和合并糖尿病（OR=0.376,95% CI：0.173~0.818）的患者抗-HBs阳性的概率较低;且透析年限≥ 5年与合并糖尿病存在相加和相乘交互作用。结论 维持性血液透析患者0-1-6月高剂量（60 μg）乙肝疫苗接种1年免疫持久性优于20 μg,接种剂量、透析年限和合并糖尿病是免疫持久性的影响因素,透析年限≥ 5年与合并糖尿病存在相加及相乘交互作用。     

太原市美沙酮维持治疗患者HCV感染相关因素及交互作用分析

目的 分析太原市美沙酮维持治疗（MMT）患者HCV感染状况及其感染相关因素与交互作用。方法 2019年4-6月对太原市3所MMT门诊正在接受治疗的MMT患者,采用面对面问卷调查收集其一般人口学特征、吸毒情况、MMT情况、性行为、健康状况等,通过病历资料查阅MMT患者HCV检测结果,使用EpiData 3.1软件双录入数据,使用SAS 9.4软件进行统计学分析,用χ²检验进行HCV感染的单因素分析、logistic回归模型进行多因素和交互作用分析。结果 MMT患者846例中,男女性别比7.21：1（743：103）,HCV感染率为12.53%（106/846）。控制混杂因素后,女性（OR=1.936,95%CI：1.023~3.662）、性伴有吸毒史（OR=2.073,95%CI：1.110~3.871）和注射吸毒者（OR=7.737,95%CI：4.614~12.973）的感染HCV风险较高。交互作用结果显示,女性、性伴有吸毒史者及注射吸毒者之间存在相乘交互作用。结论 太原市MMT患者中,女性、性伴有吸毒史者、注射吸毒者HCV感染的风险较高,女性与性伴有吸毒史者、女性与注射吸毒者、性伴有吸毒史者与注射吸毒者对HCV感染的发生存在相乘交互作用。     

Peripheric smell regions in patients with temporal and frontal lobe epilepsies: An MRI evaluation

ObjectivesWe investigated peripheric smell regions of olfactory bulb (OB) volume and olfactory sulcus (OS) depth in temporal and frontal lobe epilepsy patients by cranial magnetic resonance imaging (MRI).MethodsIn this retrospective study, cranial MRI images of 150 adult patients were included. Group 1 was consisted of 50 adult patients with temporal lobe epilepsy (TLE). Group 2 was consisted of 50 adult patients with frontal lobe epilepsy (FLE). The control group (Group 3) was consisted of 50 healthy subjects without epilepsy. OB volume and OS depth were measured in all groups.ResultsOB volumes of the temporal and frontal epilepsy groups were significantly lower than those of the control group (p_adjusted < 0.0175). However, OS depths were not different between groups 1–3 (p > 0.05). In the temporal and frontal epilepsy groups, there were positive correlations between OB volumes; OS depths; left OB volume and bilateral OS depths p < 0.05). There were no significant correlations between OB volume and OS depth; and age and gender of the epilepsy group (p > 0.05).ConclusionWe concluded that temporal and frontal epilepsy maybe related to decrease in OB volume and may cause olfactory impairment. Olfactory deficit maybe related to central epileptic focus. Therefore, early diagnosis and appropriate treatment of epilepsy are important to prevent olfactory impairment.