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1.
Traditionally, surgical management of zygomaticomaxillary complex (ZMC) and orbital fractures occurs within two to three weeks of the injury, followed by an overnight admission to allow for extended eye observations. This is due to the risk of postoperative retrobulbar haemorrhage (RBH) or orbital compartment syndrome (OCS), a rapidly progressive and sight threatening emergency that requires immediate intervention. In September 2016 the oral and maxillofacial surgery (OMFS) department at Leeds Teaching Hospitals redesigned their trauma service with a full-time trauma consultant, a dedicated clinic, and a weekly morning elective trauma theatre list. This allowed for standardisation of the management of patients with OMFS injuries. Furthermore, a formal day-case ZMC and orbital fracture pathway was developed to allow patients to undergo surgical management of such fractures with a same-day discharge. This has since been identified as an area of excellence by the Getting It Right First Time (GIRFT) programme, and is in line with the addition of ZMC and orbital fractures to the procedural list written by the British Association of Day Case Surgery (BADS). Unbeknown to the unit, the volume of day-case procedures was the highest within the UK, demonstrating the importance of GIRFT in highlighting areas of good or unique practice. The aim of this study was to determine the impact of our day-case pathway and designated OMFS trauma service on compliance with recent recommendations by GIRFT and BADS. Secondly, it was to determine the safety of same-day discharge with regards to postoperative complications.  相似文献   
2.
The representation of nursing faculty of color is disproportionate to that in the general population, despite recruitment and retention strategies. Boosting the presence of nursing faculty of color requires an understanding of factors that undermine diversity initiatives and calls for the adoption of innovative practices. This article addresses the importance of racial and ethnic diversity within nursing education. Furthermore, it examines the factors that prevent the recruitment and retention of a racially and ethnically diverse nursing faculty workforce and provides evidence-based recommendations for increasing diversity among nursing faculty and nursing organizations.  相似文献   
3.
《Human immunology》2022,83(1):1-9
The class I and class II Human Leucocyte Antigens (HLA) are an integral part of the host adaptive immune system against viral infections. The characterization of HLA allele frequency in the population can play an important role in determining whether HLA antigens contribute to viral susceptibility. In this regard, global efforts are currently underway to study possible correlations between HLA alleles with the occurrence and severity of SARS-CoV-2 infection. Specifically, this study examined the possible association between specific HLA alleles and susceptibility to SARS-CoV-2 in a population from the United Arab Emirates (UAE). The frequencies of HLA class I (HLA-A, -B, and -C) and HLA class II alleles (HLA-DRB1 and -DQB1); defined using Next Generation Sequencing (NGS); from 115 UAE nationals with mild, moderate, and severe SARS-CoV-2 infection are presented here. HLA alleles and supertypes were compared between hospitalized and non-hospitalized subjects. Statistical significance was observed between certain HLA alleles and supertypes and the severity of the infection. Specifically, alleles HLA-B*51:01 and HLA-A*26:01 showed a negative association (suggestive of protection), whilst genotypes HLA-A*03:01, HLA-DRB1*15:01, and supertype B44 showed a positive association (suggestive of predisposition) to COVID-19 severity. The results support the potential use of HLA testing to differentiate between patients who require specific clinical management strategies.  相似文献   
4.
采用静息态功能性磁共振成像(rs-fMRI)数据探究青少年肌阵挛癫痫(JME)患者大尺度脑网络的变化。采集17例JME患者和15名正常志愿者的脑部静息态功能磁共振成像数据,两组均使用偏相关系数构建静息态脑网络。分别计算JME患者组与正常对照组的阈值,构建二值化脑网络。计算两组被试各个脑区的介数值,采用双样本t检验对比两组脑网络介数值的差异(Bonferroni 校正,P<0.01),找出介数值发生显著变化脑区。结果表明,偏相关系数构造的脑网络具有小世界属性。JME患者组脑网络中脑区的介数值相比正常对照组有显著性差异。与正常对照组相比,JME患者组介数值显著降低的脑区有2个,介数值显著升高的脑区有17个。其中属于默认模式网络(DMN)的脑区有8个,属于突显网络(SN)的脑区有5个。JME患者组介数值显著降低的脑区有右侧中央旁小叶和右侧后扣带回,介数值显著增高脑区主要是右侧背外侧额上回、左侧枕中回、右侧楔前叶和右侧舌回等。JME患者介数值发生显著改变的脑区主要属于默认模式网络和突显网络。可以推断出默认模式网络和突显网络内部脑区间连接发生改变,信息传递产生变化。由此可能会导致JME患者大脑功能发生改变,造成患者的认知能力与执行能力等功能受损。  相似文献   
5.

Objective

To examine the experience of interracial anxiety among health professionals and how it may affect the quality of their interactions with patients from racially marginalized populations. We explored the influence of prior interracial exposure—specifically through childhood neighborhoods, college student bodies, and friend groups—on interracial anxiety among medical students and residents. We also examined whether levels of interracial anxiety change from medical school through residency.

Data Source

Web-based longitudinal survey data from the Medical Student Cognitive Habits and Growth Evaluation Study.

Study Design

We used a retrospective longitudinal design with four observations for each trainee. The study population consisted of non-Black US medical trainees surveyed in their 1st and 4th years of medical school and 2nd and 3rd years of residency. Mixed effects longitudinal models were used to assess predictors of interracial anxiety and assess changes in interracial anxiety scores over time.

Principal Findings

In total, 3155 non-Black medical trainees were followed for 7 years. Seventy-eight percent grew up in predominantly White neighborhoods. Living in predominantly White neighborhoods and having less racially diverse friends were associated with higher levels of interracial anxiety among medical trainees. Trainees' interracial anxiety scores did not substantially change over time; interracial anxiety was highest in the 1st year of medical school, lowest in the 4th year, and increased slightly during residency.

Conclusions

Neighborhood and friend group composition had independent effects on interracial anxiety, indicating that premedical racial socialization may affect medical trainees' preparedness to interact effectively with diverse patient populations. Additionally, the lack of substantial change in interracial anxiety throughout medical training suggests the importance of providing curricular tools and structure (e.g., instituting interracial cooperative learning activities) to foster the development of healthy interracial relationships.  相似文献   
6.
《Drug discovery today》2022,27(5):1367-1380
The tremendous advances in genomics, recombinant DNA technology, bioengineering and nanotechnology, in conjunction with the development of high-end computations, have been instrumental in the process of rational design of peptide-based vaccines. The use of peptide vaccines was limited owing to their inherent instability when systemically administered; however, advanced formulation techniques have been developed for their systemic delivery, thereby overcoming their degradation, clearance, cellular uptake and off-target effects. With the rise of sophisticated immunological predictors and experimental techniques, several methodological advances have occurred in this field. This review examines contemporary methods to identify and optimize epitopes, engineer their immunogenic properties and develop their safe and efficient delivery into the host.  相似文献   
7.
目的 了解贵州省鸡源空肠弯曲菌的分子流行特征,阐明各地菌株间的亲缘关系和进化特征。方法 在贵州省随机抽取7个大型养鸡场,共采集210份鸡的新鲜粪便样本,分离培养出38株空肠弯曲菌,采用多位点序列分型对分离株的序列型及克隆复合体进行构成和聚类分析,与PubMLST数据库中来自国内的分离株分子特征进行比较。结果 贵州省38株鸡源空肠弯曲菌分为23种ST型和8个克隆复合体,其中9种是目前中国大陆地区已有的ST型,2个等位基因和8种序列型为新发现的。ST型构成比前四位分别是ST - 45、ST - 161、ST - 354、ST - 4 324,与数据库中已有的6株贵州来源菌株相比,不存在共同的ST型。优势克隆复合体(CC - 45、CC - 354、CC - 52)与数据库中鸡源分离株的前三位克隆复合体没有重叠。菌株遗传进化树显示,本研究中属于优势克隆复合体的18株菌与国内部分人源、猪源、野生鸟源、鹅源分离株有较近的遗传距离。结论 贵州省鸡源空肠弯曲菌具有高度遗传多样性,在一定程度上表现出地域流行特征。序列型与国内华东地区的分离株有较高的交叉性,部分分离株与国内人、野生鸟、鹅等来源分离株遗传距离近,应加强对不同地区、不同宿主来源空肠弯曲菌的动态监测。  相似文献   
8.
周艺默  张立娜 《磁共振成像》2022,13(2):152-154,166
保留乳头乳房切除术(nipple-sparing mastectomy,NSM)因较高的肿瘤学安全性以及较好的美学效果,成为越来越多的乳腺癌患者治疗或高患癌风险女性预防性切除的首选。而在术前评价乳头乳晕复合体(nipple-areola complex,NAC)受累情况,选择适合NSM的患者则是亟待解决的重点和难题。本文介绍了近年来应用影像学手段术前预测NAC受累的研究进展及其优缺点,为外科医生后续手术方式的选择提供了重要信息。  相似文献   
9.
IntroductionCo-infection of nontuberculous mycobacteria (NTM) with other bacteria is associated with increased frequency of hospitalization and reduced quality of life. However, the clinical significance of co-infection with NTM and other bacteria remains unclear. Here, we investigated the distribution of alveolar macrophage populations, characterized their phagocytic function in bronchoalveolar lavage fluid (BALF), and assessed the bactericidal function of macrophages infected with NTM using cell lines.MethodsBALF samples were prospectively obtained from 30 patients with suspected NTM lung disease to evaluate phagocytic activities of macrophages using immunostaining. Bactericidal activities of Staphylococcus aureus (S. aureus) and Mycobacterium intracellulare (M. intracellulare)-infected or -non-infected macrophages were evaluated using macrophage cell lines.ResultsEleven patients with Mycobacterium avium complex (MAC) infection and 19 patients with chronic lower respiratory tract infections except for NTM infection (controls) were enrolled. The percentage of non-polarized (HLA-DR+, CD40?, and CD163?) macrophages in patients infected with MAC was significantly higher than that in controls; non-polarized macrophages demonstrated an impaired ability to phagocytose S. aureus. In vitro experiments revealed higher intracellular S. aureus colony-forming unit counts and proinflammatory cytokine levels in M. intracellulare-infected macrophages than in non-NTM-infected macrophages. Electron microscopy showed morphologically damaged macrophages and M. intracellulare and S. aureus growing in the same phagosome.ConclusionThe proportion of alveolar macrophages (HLA-DR+, CD40?, and CD163?) with impaired phagocytosis increased in MAC-infected individuals. M. intracellulare-infected macrophages reduced bactericidal activity in vitro. Dysfunction of alveolar macrophages may contribute to persistent infection by other bacteria, leading to MAC lung disease progression.  相似文献   
10.
IntroductionPremature children birth and survival is becoming more frequent due to the improvement in obstetric and neonatal care. This makes it increasingly common to find patients with history of preterm birth in ophthalmology clinics, both in pediatric and adult ages. Premature birth can lead to ocular structural changes, being possible to affect the ganglion cell complex (GCC), among other structures, which can be studied using optical coherence tomography.Materials and methodsTo carry out a bibliographic review of the studies that analyze GCC in patients with a history of prematurity compared with patients born at term.ResultsSeveral studies that analyze GCC in patients with a history of prematurity are referenced and their results are studied.ConclusionsIn our clinical practice, knowing the history of prematurity is fundamental in the assessment of GCC measured by optical coherence tomography, since this layer is different in the patients with a history of prematurity compared to patients born at term.  相似文献   
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