Guidelines on the Treatment of Chronic Coinfection by Trypanosoma cruzi and HIV Outside Endemic Areas

Abstract

As a result of population migration, Chagas disease is no longer limited to the North and South American continents. In HIV-infected patients, chronic infection by Try-panosoma cruzi behaves as an opportunistic infection in severely immunosuppressed patients and is responsible for high morbidity and mortality. Unlike other opportunistic infections, information on the natural history, diagnosis, treatment, and prevention of Chagas disease is scarce. Spain has the highest number of cases of Chagas disease outside the North and South American continents, and coinfection with HIV is increasingly prevalent. In this article, the Spanish Society for Tropical Medicine and International Health (Sociedad Española de Medicina Tropical y Salud Interna-cional) reviews the current situation of coinfection with HIV and T. cruzi infection and provides guidelines on the diagnosis, treatment, and prevention in areas where Cha-gas disease is not endemic. It also identifies areas of uncertainty where additional research is necessary.     

Calgary-Cambridge会谈指南用于护生治疗性沟通教学实践

目的探讨Calgary-Cambridge会谈指南在护生实习期间治疗性沟通实践教学中的应用效果。方法采用随机数字表将167名实习护生分为实验组(84人)和对照组(83人),实验组按照Calgary-Cambridge会谈指南对护生进行治疗性沟通临床实践指导,包括开始会谈、收集信息、提供访谈结构、建立关系、解释和计划、结束会谈共6个步骤,对照组采用常规沟通指导,实习前后分别采用护生临床沟通能力测评量表进行测评。结果实习结束后,实验组护生沟通能力总分及5个维度(除建立和谐关系维度外)评分显著高于对照组(P0.05,P0.01)。结论在临床实践活动中,采用Calgary-Cambridge会谈指南对护生进行护患沟通技能训练,效果优于常规方法。     

Guideline for translation and national validation of the Quality of Life in Hand Eczema Questionnaire (QOLHEQ)

There is a need for well‐developed and validated questionnaires to measure patient reported outcomes. The Quality of Life in Hand Eczema Questionnaire (QOLHEQ) is such a validated instrument measuring disease‐specific health‐related quality of life in hand eczema patients. A re‐validation of measurement properties is required before an instrument is used in a new population. With the objective of arriving at a guideline for translation and national validation of the QOLHEQ, we have developed the design of a reference study on how to adequately assess measurement properties of the QOLHEQ based on interdisciplinary discussions and current standards. We present a step‐by‐step guideline to assess translation (including cross‐cultural adaptation), scale structure, validity, reproducibility, responsiveness, and interpretability. We describe which outcomes should be reported for each measurement property, and give advice on how to calculate these. It is also specified which sample size is needed, how to deal with missing data, and which cutoff values should be applied for the measurement properties assessed during the validation process. In conclusion, this guideline, presenting a reference validation study for the QOLHEQ, creates the possibility to harmonize the national validation of the various language versions of the QOLHEQ.     

《FIGO 2018癌症报告》——子宫肉瘤诊治指南解读

正子宫肉瘤约占所有女性生殖道恶性肿瘤的1%,子宫体恶性肿瘤的3%～7%。因其罕见和组织病理学的多样性,目前仍缺乏最佳治疗方案和与不良预后相关的危险因素的共识。子宫肉瘤的亚型有平滑肌肉瘤、子宫内膜间质肉瘤(ESS)和子宫腺肉瘤。目前,癌肉瘤被认为     

Pediatric Perioperative DNR Orders: A Case Series in a Children's Hospital

Context

Do-not-resuscitate (DNR) orders are common among children receiving palliative care, who may nevertheless benefit from surgery and other procedures. Although anesthesia, surgery, and pediatric guidelines recommend systematic reconsideration of DNR orders in the perioperative period, data regarding how clinicians evaluate and manage DNR orders in the perioperative period are limited.