消化系癌症并发抑郁症发病情况及相关因素分析

目的了解消化系癌症（DC）患者抑郁症发病情况并探讨其相关因素。方法收集2008年6月～2011年3月两所三级甲等医院多个科室的DC患者321例,进行抑郁自评量表（SDS）和Hamilton抑郁量表（HAMD）的评定及抑郁相关因素调查,收回有效问卷315份,研究DC并发抑郁症的发病情况,进行相关因素分析。结果DC患者抑郁发生率为44．76％,以轻、中度程度为主,与文化程度和TNM分期有关。结论DC患者抑郁发生率较高,与文化程度和TNM分期相关,临床应加以辨识。     

Enrichissement alimentaire après fracture ostéoporotique au cours d’une réhabilitation en soins de suite et réadaptation orthogériatrique : intérêt nutritionnel et/ou fonctionnel ?

Materials and methodsThe study was retrospective, controlled, randomized, and was conducted from June 15, 2015 to July 31, 2016 in the orthogeriatric rehabilitation care unit of the Charles-Foix Hospital (Assistance publique–Hôpitaux de Paris). The population named group A benefiting from dietary enrichment in addition to traditional high protein hospital food was compared with a group B benefiting only from the high protein traditional hospital food. The comparison concerned the variation in weight, body mass index, albuminemia, length of stay, walking perimeter, autonomy and destination after hospitalization.ResultsIn total, 144 patients (mean age 86 years; females 84%) were included, with 79 people in group A and 65 in group B. All patients lost weight: −2.08 kg in group A and −0.30 kg in group B (P = 0.02). All patients improved albuminemia level with +3.84 g/L in group A and +2.73 g/L in group B, without significant difference. The recovery of walking and autonomy, and destination after hospitalization were comparable in both groups. The length of hospital stay in group A was shorter than in group B, with respectively 43 ± 23 days and 52 ± 33 days (P = 0.04).ConclusionDietary enrichment in elderly patients after fracture in orthogeriatric rehabilitation care unit allowed a decrease of the length of hospital stay, but does not improve nutritional and functional status.     

Uncertainty about effects is a key factor influencing institutional review boards' approval of clinical studies

PurposeTo investigate factors, which influence institutional review boards' (IRBs') decision to approve or not approve clinical studies, a nationwide vignette-based online survey of IRB members was conducted.MethodsA factorial design was used, whereby seven aspects of each hypothetical study were randomly varied in 15 phrases in each vignette to produce unique vignettes. Participants indicated the degree of study approval and described factors influencing approval decision. Qualitative responses were thematically content analyzed.ResultsSixteen themes were obtained from 208 participants from 42 institutions. Uncertainty, adherence, study design, and harms were frequently and intensely cited to influence study approval. Analysis of two extreme subgroups (approvers vs. nonapprovers) showed that uncertainty influenced approval decisions, odds ratios (OR) = 3.5 (95% confidence interval [CI], 1.3–9.8) and OR = 3.2 (95% CI, 1.1–8.9), respectively, based on theme frequency and theme intensity, ignoring multiple observations per person. Taking into consideration multiple observations per person, similar results were obtained for uncertainty: OR = 8.9 (95% CI, 0.93–85.4).ConclusionsPerceived uncertainty about benefits and harms of a proposed intervention is a key driver in IRB members' approval of clinical trials. This, in turn, calls for improved standardization in the communications of information on benefits and harms in the research protocols considered by the IRBs.     

COI vs Ct: comparing automated antigen tests cut-off index (COI) to PCR cycle threshold (Ct)

IntroductionThe objective of this study was to compare the numeric cut-off index (COI) of automated antigen tests with the cycle-threshold (Ct) value.Materials and methodsCOI values of all samples processed with the Elecsys® SARS-CoV-2 Antigen (Roche, Switzerland) from January to February 2022 were retrieved and the positive were compared to RdRP Cts of Allplex Variants I (Seegene, Korea). COI between 0.6 and 1 were considered indeterminate and overproved by RT-PCR.ResultsFrom 13,937 samples 7944(57%) were positive and 189(1.35%) indeterminate. There was a strong correlation between Cts and COI values at the positive samples, but that was not the case for indeterminates.ConclusionsCOI values of the positive samples (COI >1) are comparable to Ct values and may therefore be used as proxy viral loads, however this is not the case for indeterminate samples.     

Detection and molecular characterization of rabies virus isolates from humans in Cameroon

Despite the enzootic cycle of rabies in dog populations, laboratory confirmation of human rabies has been hardly reported in Cameroon. This study aimed to determine the rate of molecular detection and phylogenetic relatedness of Rabies Virus (RABV) isolates from suspected human rabies cases in Cameroon. From 2014 to 2018, 21 suspected human rabies cases were tested for RABV genomic RNA. Full-length sequence of the nucleoprotein (N) coding gene of RABV isolates detected were generated and subjected to phylogenetic analyses. As results, skin biopsies and/or saliva samples from 10 of the 21 suspected human rabies cases were positive for genomic RABV RNA. Four new N gene sequences were generated from confirmed cases. The studied RABV isolates fell into the Cosmopolitan clades, sub-clades Africa-1a and 1b. This study showed a low rate of molecular detection of RABV in suspected human rabies cases; thus, underscoring the interest of systematic laboratory confirmation.     

Plasma cell-free metagenomic next generation sequencing in the clinical setting for the diagnosis of infectious diseases: a systematic review and meta-analysis

Plasma cell-free metagenomic next-generation sequencing (cf-mNGS) is a non-invasive method that may be able to identify thousands of pathogens through a hypothesis-free approach. There is a lack of consensus on how this test compares to conventional microbiologic testing. We conducted a systematic review and meta-analysis of published studies evaluating the accuracy of plasma cf-mNGS in hospitalized patients and present pooled estimates of the positive (PPA) and negative percent agreement (NPA) compared to a composite reference standard that included all conventional microbiological testing and clinical history as assessed by an adjudication panel or clinical treatment team. Five retrospective studies (n = 552) were included. The majority of the patients (56%?88%) were immunocompromised. The pooled PPA was 67% (95% CI, 54%?81%) and the pooled NPA was 70% (95% CI, 63%?77%). The pooled diagnostic performance characteristics suggest that cf-mNGS provides limited evidence for ruling in or out the presence of infection as commonly used.