正念减压疗法对妊娠呕吐妇女负性情绪和生活质量的影响

目的 探析正念减压疗法对妊娠呕吐妇女负性情绪和生活质量的影响。 方法 将2017年5月-2018年5月在我院治疗的90例妊娠呕吐妇女纳入本研究,采用数字表法随机分成研究组和对照组,每组各45例。对照组接受宣教,研究组在对照组上实施正念减压疗法。分别于入组时、干预4周和干预8周采用焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、生活质量综合评定问卷(generic quality of life inventory-74,GQOLI-74)进行评估,比较2组妊娠呕吐妇女负性情绪和生活质量。 结果 2组SAS、SDS评分及生活质量综合评定问卷总分在组间效应、时间效应及交互效应上差异具统计学意义。 结论 妊娠呕吐妇女进行正念减压疗法,能够显著减轻妊娠呕吐妇女负性情绪和提高生活质量,值得在临床上广泛应用。     

Infección por el virus de la hepatitis C y nuevas estrategias de tratamiento

Hepatitis C is a major public health problem worldwide. This disease is caused by the hepatitis C virus, which is characterised by its genetic diversity. The infection is usually asymptomatic. However, between 60% and 80% of HCV-infected individuals will progress to chronic hepatitis, 20% to liver cirrhosis in the medium-to long-term and, each year, between 1% and 4% of these patients with cirrhosis will develop hepatocellular carcinoma (HCC). A Spanish consensus document has recently been drafted to diagnose hepatitis C in a single step, consisting of active investigation (antibodies and viremia) in a single sample, which according to the experts, would reduce the time to access treatment and avoid tracking losses. To definitively change the hepatitis C treatment paradigm, direct-acting antiviral drugs (DAAs) have been approved, whose development has been based on achieving cure rates close to 100% regardless of the genotype of the virus, ie, pangenotypes, with good tolerance and bioavailability. These drugs have constituted a real therapeutic revolution. Supplement information: This article is part of a supplement entitled «SEIMC External Quality Control Programme. Year 2016», which is sponsored by Roche, Vircell Microbiologists, Abbott Molecular and Francisco Soria Melguizo, S.A.© 2019 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosasy Microbiología Clínica. All rights reserved.     

失眠患者睡眠质量与心理健康状况的相关性研究

目的:探索原发性失眠患者睡眠质量与心理健康状况的关系。方法:采用横断面的研究方法,选取2015年7月至2017年7月北京中医药大学第三附属医院收治的符合纳入标准的原发性失眠患者308例作为研究对象,以PSQI、SCL-90采集原发性失眠患者的睡眠质量、心理健康状况等资料进行统计分析。结果:308例失眠患者的PSQI总分均值为(12.65±3.04),241例SCL-90筛选阳性。失眠患者SCL-90各因子测评结果除偏执、敌对外均与全国常模比较差异有统计学意义(P<0.01)。睡眠、饮食方面不适的患者211例,伴强迫者144例,伴焦虑者86例。睡眠质量、催眠药物、PSQI总分与SCL-90各因子显著正相关,此外强迫与睡眠障碍呈中度正相关。结论:失眠患者的心理健康水平较正常人差。失眠患者伴有最多的3种自觉症状为睡眠饮食不适感、强迫及焦虑。失眠患者的睡眠质量、药物使用情况及睡眠整体状况与其心理障碍相互影响,强迫与睡眠障碍有较强的相关性。     

Validation of the Functional Assessment of Cancer Therapy with Cervical Cancer Subscale (FACT-CX) for Quality of Life in Thai Patients Prior to Chemoradiotherapy

Objective: Cervical cancer is the second most common cancer in Thailand. For cervical cancer, there is no cancer specific quality of life questionnaire. This study aims to develop and validate Thai FACT-CX. Methods: The cross-sectional study included all women aged ≥18 years with stage IB2-IIIB who planned to undergo chemoradiotherapy. Those who did not understand Thai language, had other cancers (except for skin cancer), were diagnosed with impaired cognition and/or overt psychosis, and major depression were excluded. The FACT-CX comprises 42 items with 5 domains and a score range of 0-168. The WHOQOL-BREF comprises 26 items with 4 domains and a score range of 26-130. The participants were interviewed about demographic and clinical data. Both questionnaires were self-completed.  Factor analysis was used to compare our data with the previous structure. The reliability used Cronbach’s alpha. Spearman’s correlation determined relationship between the domains of the modified FACT-CX and WHOQOL-BREF. Both questionnaires were compared with socioeconomic and clinical variables using the Ranksum test and Kruskal-Wallis test. P-value > 0.05 considered significant. Results: The 245 participants included. Expletory factor analysis revealed an accumulative variance of 0.42 with 4 factors. The internal consistency was 0.84, 0.81, 0.78, 0.77 and 0.90 for perception of self, suffering symptoms, family support, life resilience and total questions. There was correlation between the domains of the modified FACT-CX and WHOQOL-BREF.  Both the modified FACT-CX and WHOQOL-BREF could identify differences between the groups of patients. Conclusion: Finally, the Thai modified FACT-CX was found to be reliable and valid for measuring quality of life among untreated cervical cancer patients.     

内热针松解术治疗腰椎间盘突出症的疗效与安全性

目的 对内热针松解术治疗腰椎间盘突出症的疗效与安全性进行评价。方法 研究对象为我院2019年1月～2020年1月期间收治的50例腰椎间盘突出症患者，按照数字表法将其随机分为实验组与对照组，每组各25例，实验组使用内热针松解术进行治疗，对照组使用常规理疗进行治疗。对比分析两组患者VAS评分、SF-36评分、不良反应发生情况。结果 两组患者治疗1个月后与治疗3个月后的VAS评分显著低于治疗前、SF-36的各维度评分显著高于治疗前（P＜0.05），且实验组显著优于对照组（P＜0.05）；实验组不良反应总发生率显著低于对照组（P＜0.05）。结论 在腰椎间盘突出症治疗中使用内热针松解术，可有效减轻患者疼痛，提高患者生活质量，降低不良反应发生率，安全性良好，疗效显著。     

The Preventable Productivity Burden of Kidney Disease in Australia

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Thalamic deep brain stimulation for Tourette Syndrome: A naturalistic trial with brief randomized,double-blinded sham-controlled periods

BackgroundThere is still a lack of controlled studies to prove efficacy of thalamic deep brain stimulation for Tourette's Syndrome.ObjectivesIn this controlled trial, we investigated the course of tic severity, comorbidities and quality of life during thalamic stimulation and whether changes in tic severity can be assigned to ongoing compared to sham stimulation.MethodsWe included eight adult patients with medically refractory Tourette's syndrome. Bilateral electrodes were implanted in the centromedian-parafascicular-complex and the nucleus ventro-oralis internus. Tic severity, quality of life and comorbidities were assessed before surgery as well as six and twelve months after. Short randomized, double-blinded sham-controlled crossover sequences with either active or sham stimulation were implemented at both six- and twelve-months’ assessments. The primary outcome measurement was the difference in the Yale Global Tic Severity Scale tic score between active and sham stimulation. Adverse events were systematically surveyed for all patients to evaluate safety.ResultsActive stimulation resulted in significantly higher tic reductions than sham stimulation (F = 79.5; p = 0.001). Overall quality of life and comorbidities improved significantly in the open-label-phase. Over the course of the trial two severe adverse events occurred that were resolved without sequelae.ConclusionOur results provide evidence that thalamic stimulation is effective in improving tic severity and overall quality of life. Crucially, the reduction of tic severity was primarily driven by active stimulation. Further research may focus on improving stimulation protocols and refining patient selection to improve efficacy and safety of deep brain stimulation for Tourette's Syndrome.     

Child and parent perspectives of life quality of children with physical impairments compared with non-disabled peers

Background: Life quality has become a widely used concept within rehabilitation and occupational therapy practice.

Aim: This study explored child and parent perspectives of life quality of children with physical impairments compared with a group of non-disabled children.

Method: Data were collected with the Icelandic self- and proxy-reported versions of the KIDSCREEN-27. For children with physical impairments, reports from 34 children and 40 parents were included in the analyses, and in control group reports from 429 children and 450 parents were included.

Results: Children with physical impairments evaluated their life quality within the average range on four out of five life quality dimensions. The lowest scores were within the physical well-being dimension. Self-reported scores of children with physical impairments were higher than those of their parents on all dimensions except autonomy and parent relations. Thus, the parents considered more environmental and personal factors to negatively influence their child’s life quality than children did themselves.

Conclusion: Children with physical impairments experience their life quality similarly to non-disabled children.

Significance: Focus on life quality can help occupational therapists to identify what circumstances positively or negatively influence client well-being and to focus more on contextual factors that contribute to disablement.     

A discussion of the unresolved 2016/17 plans for regulating the Polish dietary supplements market

The Polish dietary supplement market is growing steadily. However, even though these products may have an impact on health they are not as strongly regulated as pharmaceuticals. In 2016/17 the introduction of new regulations covering the marketing of dietary supplements in Poland was proposed. This article briefly describes the Polish market for dietary supplements and assesses the benefits and risks associated with its development. A range of potential legislative changes, such as a total ban on dietary supplements, a ban on using the images and recommendations of authoritative entities, increased fines for breaking the law, and other measures are under consideration. We describe the advantages (e.g., better customer protection, and the limitation of inappropriate, misleading advertising) and disadvantages (e.g., a decrease in product innovation, deterioration in product offerings, and rises in product prices) of the proposed changes. As a European Union member, Poland adopts EU law, but EU directives have only harmonized some issues relating to dietary supplement marketing, other key aspects remaining within the competence of member states, but it is noted that some proposed changes in Polish law (e.g., an advertising ban) are so strict that they are unlikely to be acceptable to the EU.