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Lucia Taramasso Paolo Bonfanti Elena Ricci Paolo Maggi Giancarlo Orofino Nicola Squillace Barbara Menzaghi Giordano Madeddu Chiara Molteni Francesca Vichi Erika Riguccini Annalisa Saracino Carmen Santoro Marta Guastavigna Daniela Francisci Antonio Di Biagio Giuseppe Vittorio De Socio 《HIV medicine》2022,23(1):70-79
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目的调查133例大学生HIV感染者新型毒品使用情况、危险性行为特征,分析两者间的相关性。方法对某省会城市133例在校大学生HIV感染者进行匿名问卷调查,收集调查对象新型毒品使用、危险性行为特征的相关信息,采用二分类非条件Logistic回归模型分析新型毒品使用与危险性行为特征的相关性。结果 37.6%(50/133)的调查对象在HIV阳性诊断之前已开始使用新型毒品,46.6%(62/133)报告过去6个月使用过新型毒品,9.0%(12/133)在过去6个月使用过冰毒,Rush则为男男性行为感染者最常使用的新型毒品,占36.8%(49/133)。多因素分析显示,控制其他因素,新型毒品使用与大学生HIV感染者群交性行为(OR=4.08,95%CI:1.57~10.59)、临时性行为(OR=4.13,95%CI:1.67~10.22)、无保护性行为(OR=3.22,95%CI:1.36~7.60)、商业性性行为(OR=9.25,95%CI:1.88~45.58)呈正相关。结论新型毒品使用伴随危险性行为增加,提示今后在大学生HIV感染者当中,应加强健康干预工作并制订更具有针对性的干预策略,减少其新型毒品的使用和危险性行为的发生。 相似文献
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目的 探讨危重型急性胰腺炎(CAP)进一步分型的价值。方法 回顾性分析2010年1月至2021年2月中南大学湘雅医院胰腺外科收治的120例CAP病人的临床资料。根据CAP病人器官功能衰竭和感染性胰腺坏死是否同期发生,分为同时性CAP(69例)和异时性CAP(51例)两组,比较两组病人临床结局的差异。结果 全组病死率为42.5%(51/120),其中同时性CAP病死率为66.7%(46/69),高于异时性CAP组(9.8%,5/51),差异具有统计学意义(P<0.05)。与异时性CAP相比,同时性CAP病人多器官功能衰竭发生率更高、器官功能衰竭持续时间更长、术后出血发生率更高、ICU住院时间及总的住院时间明显延长(均P<0.05)。多因素Logistic回归分析显示,起病至IPN时间(OR=1.1,95%CI 1.0-1.2,P=0.010)、多器官功能衰竭(OR=8.3,95%CI 2.1-32.2,P=0.002)和同时性CAP(OR=9.4,95%CI 2.6-34.5,P=0.001)是CAP病人死亡的独立预后因素。结论 同时性CAP是早期器官功能衰竭进行的同时并发感染性胰腺坏死,预后极差。对CAP做进一步分型有助于指导对其预后判断和治疗方式的选择。 相似文献
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目的 构建基于百度指数的CEEMD - GRNN模型预测HIV感染病例数、为信息缺乏的HIV感染疫情预测提供可靠的方法,旨在为艾滋病流行趋势的传统预测方法提供有益补充。方法 第一,利用GRNN建立HIV感染病例数原始序列与百度指数的非线性关系;第二,先利用CEEMD提取HIV感染病例数的周期,再利用GRNN建立提取后序列与百度指数的非线性关系;第三,基于上述两种思想进一步建立组合预测模型,称为CEEMD - GRNN组合模型;最后,将CEEMD - GRNN组合模型应用于HIV感染病例数的预测。结果 模型拟合结果表明,最优单项模型的MAPE为10.17%,CEEMD - GRNN组合模型的MAPE为7.18%,组合模型的预测精度高于最优单项模型。结论 本文提出的CEEMD - GRNN组合模型预测精度优于最优单项模型,所提模型能够为信息不充足的非线性HIV感染病例数据提供稳定可靠的预测方法。 相似文献
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《Clinical microbiology and infection》2022,28(12):1652.e1-1652.e6
ObjectiveAnal cancer is preceded by high-risk human papillomavirus (HRHPV) infection, predominantly HPV16. No HPV assay is licenced for use in anal screening. We aimed to determine the sensitivity and specificity of four anal canal swab HPV assays to predict high-grade squamous epithelial lesions (HSIL).MethodsIn a cohort of Australian HIV-positive and negative gay and bisexual men, we compared the sensitivity and specificity of detection of 13 anal HRHPV genotypes by Linear Array (LA), Cobas 4800, EuroArray, and Anyplex II HPV28 (+ and ++ cut offs), compared their ability to predict prevalent anal HSIL, and compared anal canal HRHPV detection with HRHPV isolated from HSIL using laser capture microdissection (LCM).ResultsA total of 475 participants had baseline results available for all four assays (166, 35.0% HIV positive), and 169 participants had a diagnosis of cytological and/or histological HSIL. The HPV16 and any HRHPV detection were highest with Anyplex II HPV28 (+) (156, 32.8% 95% CI 28.6–37.2 and 359, 75.6%, 95% CI 71.5–79.4, respectively). For detection of concurrent HSIL and HPV16, the assay sensitivity was similar, ranging from 49.1%, 95% CI 41.4–56.9 (Anyplex II HPV28 ++) to 55.0%, 95% CI 47.2–62.7 (Anyplex II HPV28 +). For concurrent HSIL and any HRHPV detection, EuroArray was more specific than Anyplex II HPV28 (+) (45.9% 95% CI 40.2–51.7 vs 36.7%, 95% CI 31.3–42.4, p = 0.021) and had comparable specificity with Anyplex II HPV28 (++) (45.9% vs 47.2%, 95% CI 41.5–53.0, p = 0.75). All assays had high sensitivities for predicting HPV16 detected on LCM (92.5–97.5%). Anyplex II HPV28 and EuroArray were significantly more sensitive than LA for lesions caused by non-HPV16 HRHPV types on LCM.DiscussionAnyplex II HPV28 and EuroArray detected more non-16 HRHPV genotypes than LA. Increasing the Anyplex II HPV28 cutoff improved specificity without compromising sensitivity for detection of concurrent HSIL. 相似文献
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Virginija Pokut Rta Kazlauskait Irmina Matonyt 《Health & social care in the community》2022,30(1):193-202
Demographic situation, changes in the role of women in society and growing demand for long-term care (LTC) of older people have challenged the ability to meet the growing LTC needs in most developed countries. In countries where responsibility for LTC is still largely laid on families, it is, however, even more critical and calls for improvements in formal LTC systems. More intensive stakeholder collaboration in LTC policy development, organising and delivery are of primary importance in improving LTC systems. Such collaboration, however, is not always successful; thus, it is critical to understand what makes it effective and efficient. In this paper, we specifically look into multistakeholder collaboration in LTC in Lithuania, one of the fastest ageing countries in the EU, with the demand for LTC services growing fast and exceeding the supply despite rising business and NGO engagement. To determine facilitators of such collaboration, we build on the data obtained through eight focus group discussions with all key stakeholder representatives (LTC policymakers, organisers and service providers [public, private and NGOs], 54 participants in total). Our findings indicate that in addition to national and organisational level facilitators studied in prior research, there are important individual level factors, such as meaningfulness at work, concern and care for others, possibility for personal growth and development, satisfaction with supervision, a sense of belonging and role clarity. On the other hand, our results show that collaboration is constrained by a shortage of human resources, increased workload caused by growing LTC demand, bureaucratic requirements, legal restrictions, lack of awareness of LTC service availability among elder persons, and prevailing social norms and attitudes to institutionalised care. Interestingly, a lack of financial resources is not perceived as a major constraint. 相似文献
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《Gait & posture》2022
BackgroundTextured insoles have been suggested to enhance foot sensation, which contributes to controlling upright balance. However, the interaction between plantar callosity and the textured surface has not been studied.Research questionFirstly, to compare the efficacy of textured insoles on balance performance and foot position sense between two groups of older people: one group had plantar callosity, and the other did not. Secondly, to investigate the efficacy of textured insoles within each study group.MethodsThirty older people with a history of falls (15 with plantar callosity and 15 without callosity) participated in this study. All participants underwent assessments of postural sway on a force plate, joint position sensation of the ankle with a slope box, and mobility using the "Timed Up and Go" test under three insole surface conditions: 1) smooth (control), 2) placebo and 3) textured surface. Two-way analyses of variance were used to compare the outcomes of the two groups and three conditions.ResultsOlder people with plantar callosity had worse ankle joint position sense and slower antero-posterior and mediolateral postural sway velocity than their peers who did not have plantar callosity. The textured insoles improved ankle joint position sense and mobility regardless of callus status in the plantar surface of older peoples’ feet. The insole-callosity interaction was not significant for any study outcome.SignificanceTextured insoles could be beneficial to older people with and without callosity as they have shown immediate improvements in ankle joint position sense and mobility. 相似文献
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Delirium is one of the most commonly occurring postoperative complications in older adults. It occurs due to the vulnerability of cerebral functioning to pathophysiological stressors. Identification of those at increased risk of developing delirium early in the surgical pathway provides an opportunity for modification of predisposing and precipitating risk factors and effective shared decision-making. No single delirium prediction tool is used widely in surgical settings. Multi-component interventions to prevent delirium involve structured risk factor modification supported by geriatrician input; these are clinically efficacious and cost effective. Barriers to the widespread implementation of such complex interventions exist, resulting in an ‘implementation gap’. There is a lack of evidence for pharmacological prophylaxis for the prevention of delirium. Current evidence suggests that avoidance of peri-operative benzodiazepines, careful titration of anaesthetic depth guided by processed electroencephalogram monitoring and treatment of pain are the most effective strategies to minimise the risk of delirium. Addressing postoperative delirium requires a collaborative, whole pathway approach, beginning with the early identification of those patients who are at risk. The research agenda should continue to examine the potential for pharmacological prophylaxis to prevent delirium while also addressing how successful models of delirium prevention can be translated from one setting to another, underpinned by implementation science methodology. 相似文献