Cigarette électronique chez les patients fumeurs présentant une pathologie psychotique. Revue de la littérature

ObjectivesThis systematic literature review focused on patients suffering from schizophrenia (SZ), psychotic disorders or mental illness (MI) including SZ. It was interested in data on prevalence of electronic cigarette (EC) use, patient perceptions and expectations, as well as caregivers’ attitudes towards the EC and its benefit in helping to stop or reduce smoking.MethodThe research was carried out on Medline for the period 2000–2020. Cross-sectional, case-control, prospective, randomized controlled studies and preliminary studies were included in this review.ResultsEC is widely used by MI patients with current and lifetime use from 7.4% to 28.6%. More specifically, patients with SZ and schizoaffective disorders observe current and lifetime use from 7% to 36%, respectively. Many reasons are given by patients for its use including the possibility of using it in places where smoking is prohibited, its lower toxicity compared to cigarettes for oneself and those around, its lower cost, and the help provided to reduce consumption.ConclusionEC is used by smokers with MI; several studies confirm the possibility for these smokers to reduce tobacco consumption through EC and without disturbing their mental state. However, its value in helping to quit smoking remains uncertain.     

Risk factors for calcification of the vertebrobasilar arteries in cardiovascular patients referred for a head CT,the SMART study

Background and purposeVertebrobasilar artery calcification (VBAC) has been associated with increased stroke occurrence. Little is known on VBAC risk factors, especially for patients with cardiovascular disease. We aimed to assess risk factors associated with VBAC in a cohort of cardiovascular patients referred for a head computed tomography (CT) scan.Materials and methodsAll patients who underwent a clinically indicated, unenhanced, thin slice head CT 6 months before or after inclusion in the SMART study were included. CTs were assessed for presence of VBAC (dichotomously). Relative risks of the associations of age, sex, diabetes mellitus (DM), obesity, body mass index, estimated glomerular filtration rate, hypertension, hyperlipidemia, use of lipid lowering medication, smoking status, high sensitivity C-reactive protein, ankle-brachial index (ABI; ≤ 0.90, ≥ 1.30, continuous), internal carotid artery stenosis ≥ 70%, and carotid intima-media thickness (IMT) with VBAC were estimated using Poisson regression analysis with robust standard errors, adjusted for age and sex.ResultsOf the 471 patients included (57% male, median age 58 [interquartile range 47–63]), 117 (24.8%) showed VBAC. Presence of VBAC was associated with older age (RR per 10 years = 1.70 [95%CI 1.46–1.99]), DM (RR = 1.45 [95%CI 1.03–2.06]), obesity (RR = 1.53 [95%CI 1.10–2.12]), ABI ≤ 0.90 (RR = 1.57 [95%CI 1.02–2.41]), and an increased carotid IMT (RR = 2.60 per mm [95%CI 1.20–5.62]). Other measurements were not associated with VBAC.ConclusionsWe identified several markers associated with VBAC in patients with cardiovascular disease referred for a head CT. Future investigation into the relationship between VBAC and stroke is warranted to determine the potential of VBAC in stroke prevention.     

垂体腺瘤组织DCX表达水平与肿瘤侵袭性的关系

目的 探讨垂体腺瘤组织双皮质素（DCX）的表达水平与肿瘤侵袭性的关系。方法 采用免疫组化染色和qRT-PCR检测2017年1月~2020年1月手术切除的88例垂体腺瘤组织和56例瘤旁垂体组织DCX表达情况和DCX mRNA表达量。根据Knosp分类方法评估肿瘤侵袭性,并分成侵袭组、无侵袭组。利用多因素logistic回归分析检验发生侵袭性的危险因素。受试者工作特征（ROC）曲线分析DCX mRNA预测垂体腺瘤侵袭性的效能。结果 88例中,侵袭组41例,无侵袭组47例。垂体腺瘤组织DCX阳性率（71.59%,63/88）明显高于瘤旁组织（17.86%,10/56;P<0.05）。垂体腺瘤组织DCX mRNA表达量（5.65±1.87）明显高于瘤旁组织（0.85±0.28;P<0.05）。侵袭组DCX mRNA表达量（6.42±0.86）明显高于无侵袭组（4.98±0.94;P<0.05）。多因素logistic回归分析显示DCX表达阳性是垂体腺瘤发生侵袭的独立危险因素（P<0.05）。ROC曲线显示,DCX mRNA表达量预测垂体腺瘤侵袭性的曲线下面积为0.775（95% CI 0.676~0.874;P<0.001）,最佳界值为5.640,敏感度为78.00%,特异度为61.70%。结论 垂体腺瘤组织DCX呈高表达,检测DCX表达水平对肿瘤侵袭性有一定的预测作用。     

胶质瘤组织UCH37表达水平与病人预后的相关性

目的 探讨胶质瘤组织泛素化羧基末端水解酶37（UCH37）表达水平与病人预后的相关性。方法 选取2017年6月至2019年6月手术切除的脑胶质瘤组织104例和瘤旁脑组织64例,采用免疫组化法检测组织UCH37表达水平,根据免疫组化染色评分分成高表达组、低表达组;采用PCR法检测组织UCH37 mRNA水平。术后随访18个月,记录死亡、生存情况。结果 104例中,死亡20例,存活84例;UCH37高表达62例,低表达42例。脑胶质瘤组织UCH37高表达率（59.62%）明显高于瘤旁组织（17.19%;P<0.05）,而且脑胶质瘤组织UCH37 mRNA表达量明显高于瘤旁组织（P<0.05）。多因素logistic回归分析显示UCH37高表达是脑胶质瘤术后死亡的独立危险因素（P<0.05）。UCH37高表达组中位生存期（9个月）较低表达组（13个月）明显缩短（P<0.05）。ROC曲线分析显示,UCH37 mRNA评估病人术后死亡的最佳界值为2.725,曲线下面积为0.797（95%置信区间0.695~0.899）,敏感度为70.00%,特异度为70.10%。结论 脑胶质瘤UCH37呈高表达,表达水平越高,预后越差。肿瘤组织UCH37 mRNA水平检测对病人预后有一定评估价值。     

Assessing the predictive ability of the Suicide Crisis Inventory for near‐term suicidal behavior using machine learning approaches

ObjectiveThis study explores the prediction of near‐term suicidal behavior using machine learning (ML) analyses of the Suicide Crisis Inventory (SCI), which measures the Suicide Crisis Syndrome, a presuicidal mental state.MethodsSCI data were collected from high‐risk psychiatric inpatients (N = 591) grouped based on their short‐term suicidal behavior, that is, those who attempted suicide between intake and 1‐month follow‐up dates (N = 20) and those who did not (N = 571). Data were analyzed using three predictive algorithms (logistic regression, random forest, and gradient boosting) and three sampling approaches (split sample, Synthetic minority oversampling technique, and enhanced bootstrap).ResultsThe enhanced bootstrap approach considerably outperformed the other sampling approaches, with random forest (98.0% precision; 33.9% recall; 71.0% Area under the precision‐recall curve [AUPRC]; and 87.8% Area under the receiver operating characteristic [AUROC]) and gradient boosting (94.0% precision; 48.9% recall; 70.5% AUPRC; and 89.4% AUROC) algorithms performing best in predicting positive cases of near‐term suicidal behavior using this dataset.ConclusionsML can be useful in analyzing data from psychometric scales, such as the SCI, and for predicting near‐term suicidal behavior. However, in cases such as the current analysis where the data are highly imbalanced, the optimal method of measuring performance must be carefully considered and selected.     

Grafting antibiofilm polymer hydrogel film onto catheter by SARA SI-ATRP

Abstract

Catheters are widely used and play an important role in medicine. However, catheter-associated infection is prevalent even under stringent sterile conditions. Biofilms are formed when bacteria populate the surfaces of catheters. This makes the biofilm resistant to antibiotics. Hence, it is imperative for there to be an inherently antifouling and anti-bacterial catheter to mitigate the formation of biofilm. This paper aims to outline the synthesis of non-leachable anti-biofilm and anti-bacterial cationic film coatings through direct polymerization using supplemental activator and reducing agent surface initiated atom transfer radical polymerization (SARA SI-ATRP). Three crosslinked cationic coatings comprising of Diallyl dimethyl ammonium chloride (DADMAC), or ε-poly-L-lysine HCl methacrylic acid (EPL-MA) together with a crosslinker (polyethylene glycol dimethacrylate, PEGDMA) were investigated. These non-leachable covalently linked coatings with DADMAC can achieve more than 2 log reduction (99.0%) with Methicillin-resistant Staphylococcus aureus (MRSA) and 1.25 log reduction (94.4%) with Vancomycin resistant Enterococcus (VRE) in in vitro studies.     

Stimulus transformation into motor action: Dynamic graph analysis reveals a posterior‐to‐anterior shift in brain network communication of older subjects

Cognitive performance slows down with increasing age. This includes cognitive processes that are essential for the performance of a motor act, such as the slowing down in response to an external stimulus. The objective of this study was to identify aging‐associated functional changes in the brain networks that are involved in the transformation of external stimuli into motor action. To investigate this topic, we employed dynamic graphs based on phase‐locking of Electroencephalography signals recorded from healthy younger and older subjects while performing a simple visually‐cued finger‐tapping task. The network analysis yielded specific age‐related network structures varying in time in the low frequencies (2–7 Hz), which are closely connected to stimulus processing, movement initiation and execution in both age groups. The networks in older subjects, however, contained several additional, particularly interhemispheric, connections and showed an overall increased coupling density. Cluster analyses revealed reduced variability of the subnetworks in older subjects, particularly during movement preparation. In younger subjects, occipital, parietal, sensorimotor and central regions were—temporally arranged in this order—heavily involved in hub nodes. Whereas in older subjects, a hub in frontal regions preceded the noticeably delayed occurrence of sensorimotor hubs, indicating different neural information processing in older subjects. All observed changes in brain network organization, which are based on neural synchronization in the low frequencies, provide a possible neural mechanism underlying previous fMRI data, which report an overactivation, especially in the prefrontal and pre‐motor areas, associated with a loss of hemispheric lateralization in older subjects.     

Przedtransplantacyjne czynniki ryzyka reaktywacji zakażenia wirusem cytomegalii po przeszczepieniach allogenicznych komórek hematopoetycznych u dzieci i młodych dorosłych

BackgroundCytomegalovirus (CMV) reactivation remains one of the most frequent complications after allogeneic hematopoietic stem cell transplantation (HSCT).MethodsAn analysis of the pre-transplant risk factors of CMV reactivation was performed in 98 patients aged 0.5–22 years (median 10.5) undergoing allogeneic HSCT. CMV reactivation was tested by assessing viral load using PCR method. Following factors were analyzed: type of conditioning, graft source, donor type, use of T-depletion and CMV-serostatus of the donor and recipient. Each factor was assigned from 0 to 2 points. Based on total score for each patient, CMV reactivation risk scale was developed, and two groups with low (LR) and high (HR) risk were determined.ResultsCMV reactivation was seen in 25 patients (24.5%). The significant risk factors for CMV reactivation were: CMV-positive recipient (p<0.001), unrelated donor (p<0.002), use of ATG (p<0.002) and PBSC (p<0,01). In the HR group the incidence of reactivation CMV was significantly higher than in LR group (47.8% vs. 5.4%, p<0.001).ConclusionsCMV seropositivity of the recipient was an independent predictor factor of CMV reactivation. The use of risk point scale of CMV reactivation allows for identification of patients with the higher risk of CMV reactivation.     

烧伤患者医院感染危险因素的Meta分析

【摘要】 目的 系统分析烧伤患者发生医院感染的危险因素。 方法 计算机检索中国期刊全文数据库 (中国知网)、中文科技期刊数据库 (维普)、中国学术期刊数据库 (万方)、 中国生物医学文献数据库 (CBM)? PubMed、 The Cochrane Library 中 2019 年 6 月前公开发表的烧伤患者医院感染危险因素研究的文献, 根据纳入与排除标准筛选符合标准的文献, 采用纽卡斯尔-渥太华量表 (NOS) 对纳入文献进行质量评价, 采用 Rev Man 5软件对纳入文献进行统计分析。结果 共纳入符合标准的文献 13 篇, 包含烧伤患者 12537 例, 发生医院感染者1577 例, 纳入危险因素12 个, 其中年龄 (OR=2.47,95%CI为1.52～3.99）、烧伤程度 （OR=3.99,95%CI为1.42～11.22）、烧伤面积（OR=13.45,95%CI为7.74～24.21）、吸入性损伤（OR=7.22,95%CI为4.08～12.78）、糖尿病 （OR=1.49,95%CI为1.12～1.97）、预防性使用抗生素 （OR=5.55,95%CI为2.81～10.96）、手术（OR=4.85,95%CI为1.71～13.79）、气管切开 （OR=4.79,95%CI为2.19～10.49）、有创呼吸机的使用（OR=7.23,95%CI为5.04～10.38）、住院时间（OR=7.38,95%CI为2.68～20.33）是烧伤患者发生医院感染的危险因素。 结论 烧伤患者的一般情况? 疾病情况及治疗情况均可影响烧伤患者医院感染的发生 及发展, 临床治疗中应正确识别烧伤感染高危人群, 及时干预相关危险因素, 以提高治疗效果。