前瞻性护理干预在急性心力衰竭患者中的应用

目的探讨前瞻性护理干预在急性心力衰竭患者中的应用效果。方法选取2018年4月—2020年5月河南省某医院收治的122例急性心力衰竭患者为研究对象,采用随机数字表法分为观察组与对照组,每组61例。对照组患者采用常规护理,观察组患者采用前瞻性护理,比较2组患者的干预效果、并发症发生情况,干预前后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分及护理满意度。结果观察组患者干预总有效率为95.08%,高于对照组的75.41%,差异有统计学意义(χ²=9.385,P=0.002)。观察组患者并发症发生率为3.28%,低于对照组的18.03%,差异有统计学意义(χ²=6.974,P=0.008)。2组患者干预后SAS及SDS评分均低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。观察组患者护理满意度为98.36%,高于对照组的86.89%,差异有统计学意义(χ²=4.319,P=0.038)。结论前瞻性护理干预用于急性心力衰竭患者,有助于改善患者负性情绪及减少并发症的发生。     

不同手术方法治疗儿童基本型外斜视对术后侧转非共同性的影响

目的：研究不同手术方法治疗儿童基本型外斜视与术后侧转非共同性发生及矫正效果相关性。

方法：回顾性研究。选取2018-06/2020-12于我院眼科接受治疗的180例基本型外斜视患儿临床资料。根据手术方式分为单眼一退一截术组(R&R组)104例和双眼外直肌后徙术组(BLR-rec组)76例。比较两组患者一般资料、手术矫正效果，以及随访期间手术斜视度数、侧转非共同性发生情况。

结果：两组患者术后3d，1、6mo视近、视远斜视度比较均无差异(均P>0.05)。R&R组术后不同时间点正位率高于BLR-rec组(P<0.05)。R&R组较BLR-rec组发生侧转非共同性的风险更低(OR=0.524， Wald χ²=4.260， P=0.039)。两组患者术后6mo主要表现在水平直肌手术眼外展方向注视，但两组患儿视远和视近侧转非共同性发生率均无差异(均P>0.05)。

结论：R&R对于儿童基本型外斜视的矫正效果优于BLR-rec术式，可降低侧转非共同性发生情况。     

Compliance to Advisory Committee on Immunization Practices recommendations for pneumococcal vaccination

We evaluated compliance to the ACIP pneumococcal vaccination recommendations issued in 2014 for adults aged ≥ 65 years and in 2012 for adults with high-risk (HR) conditions. The MarketScan® Commercial and Medicare Supplemental databases (January 2007-June 2019) were used to identify the cohorts of interest. Analyses for adults aged ≥ 65 years were adjusted to account for missing vaccination history. Two HR cohorts were identified. The HR1 cohort included patients with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid leak, or cochlear implant. The HR2 cohort included patients with chronic heart, lung, or liver disease; diabetes mellitus; alcoholism; cirrhosis; or cigarette smoking. Full compliance for those aged ≥ 65 years or in the HR1 cohort was defined as receipt of PCV13 and PPSV23, and partial compliance was defined as receipt of PCV13 or PPSV23. For those in the HR2 cohort, full compliance was defined as receipt of PPSV23. Annual compliance rates were estimated using the Kaplan–Meier method.Among those aged ≥ 65 years, partial compliance at 4 years post index was 53% and full compliance was 17% in adjusted analyses. In subjects ≥ 65 years receiving the first vaccination, 42% received the second vaccination by year 4. For the HR1 cohort, partial compliance was 19% and full compliance was 5% at 6 years post index date. For the HR2 cohort, full compliance was 20% at 6 years, with the highest rate in patients with diabetes (27%) and the lowest rate in patients with alcoholism (8%).Additional efforts are needed to maximize compliance to the ACIP pneumococcal vaccine recommendations among adults ≥ 65 years of age and adults with HR conditions including streamlined recommendations and single-dose vaccines. These efforts may subsequently reduce the incidence and burden of pneumococcal disease.     

Safety and immunogenicity of NVX-CoV2373 (TAK-019) vaccine in healthy Japanese adults: Interim report of a phase I/II randomized controlled trial

BackgroundWe evaluated the safety and immunogenicity of NVX-CoV2373, a recombinant SARS-CoV-2 nanoparticle vaccine, in healthy Japanese participants.MethodsThis phase 1/2, randomized, observer-blind, placebo-controlled trial conducted in Japan (two sites), enrolled healthy Japanese adults aged ≥ 20 years with no history/risk of SARS-CoV-2 infection and no prior exposure to other approved/investigational SARS-CoV-2 vaccines or treatments. Participants were stratified by age (< 65 or ≥ 65 years) and randomized to receive two doses of either NVX-CoV2373 (5 μg SARS-CoV-2 rS; 50 μg Matrix-M1) or placebo, 21 days apart. Primary outcomes were safety and immunogenicity assessed by serum IgG antibody levels against SARS-CoV-2 rS protein on day 36. Herein, we report the primary data analysis at 4 weeks after the second dose, ahead of 12-month follow-up completion (data cut-off: 8 May 2021).ResultsBetween 12 February 2021 and 17 March 2021, 326 subjects were screened, and 200 participants enrolled and randomized: NVX-CoV2373, n = 150; placebo, n = 50. Solicited adverse events (AEs) through 7 days after each injection occurred in 121/150 (80.7%) and 11/50 (22.0%) participants in the NVX-CoV2373 and placebo arms, respectively. In the NVX-CoV2373 arm, tenderness and injection site pain were the most frequently reported solicited AEs after each vaccination, irrespective of age. Robust immune responses occurred with NVX-CoV2373 (n = 150) by day 36: IgG geometric mean fold rise (95% confidence interval) 259 (219, 306); seroconversion rate 100% (97.6, 100). No such response occurred with placebo (n = 49).ConclusionTwo doses of NVX-CoV2373 given with a 21-day interval demonstrated acceptable safety and induced robust anti-SARS-CoV-2 immune responses in healthy Japanese adults. Funding: Takeda Pharmaceutical Company Limited and Japan Agency for Medical Research and Development (AMED). ClinicalTrials.gov identifier: NCT04712110.     

Prevalence of periodontitis based on retrospective radiographic evaluation at dental hospital in Eastern Province of Saudi Arabia: A retrospective study

ObjectivesThe contemporary information on the prevalence of periodontitis and associated risk factors is deficient in the Kingdom of Saudi Arabia. Our aim was to measure the prevalence of periodontitis and associated risk factors among the Saudi population in the Eastern Province of Saudi Arabia who visited the University Dental Hospital.MethodsIn this retrospective study, the demographic data and medical and dental records of 700 subjects were examined. Bitewing radiographs were analyzed to measure the alveolar bone loss in posterior teeth by measuring the distance between the cementoenamel junction and the crest of the alveolar bone. A chi-square test was performed to compare the severity of periodontitis. A comparison of multivariate mean bone loss was performed using a t-test. Logistic regression analysis was used to evaluate the predictors of periodontitis. A P-value equal to or under 0.05 reflected statistical significance.ResultsAmong 700 cases, the patients’ mean age was 35.6 ± 12.1; 52.6 % were male and 47.4 % were female. Overall periodontitis prevalence was 52.1 %. The distribution of mild, moderate, and severe periodontitis prevalence was 36.1 %, 14.1 %, and 1.8 %, respectively. The severity of periodontitis was statistically similar between males and females (p = 0.148); however, significantly more Saudi than non-Saudi patients had moderate periodontitis. Higher proportions of severe periodontitis were seen in the age group of over 50-years-old (p < 0.001) and in patients with poor oral hygiene (p < 0.001), diabetes mellitus (p < 0.005), and hypertension (p < 0.002). Six total predictors of periodontitis were depicted, i.e., age > 50 years (OR = 3.73), poor OH status (OR = 2.24), BOP (OR = 3.35), presence of plaque (OR = 2.61), diabetes mellitus (OR = 3.19), and hypertension (OR = 3.62).ConclusionThe primary factors associated with the prevalence of periodontitis were age, nationality, diabetes, hypertension, BOP, plaque, and OH status. However, no association was observed between gender or cardiovascular disease and the prevalence of periodontitis in the studied population.     

慢性泪囊炎患者应用鼻内镜下鼻腔泪囊造口术的临床效果及对安全性的影响

目的探讨慢性泪囊炎患者应用鼻内镜下鼻腔泪囊造口术的临床效果及安全性。方法选取2018年1月至2019年12月因慢性泪囊炎于本院接受治疗的46例患者为研究对象,随机分为研究组与对照组,各23例。对照组接受泪囊鼻腔造口治疗,研究组取鼻内镜下鼻腔泪囊造口术治疗,比较两组临床效果、手术指标以及并发症发生情况。结果研究组治疗总有效率高于对照组(P<0.05);研究组术中出血量少于对照组,手术及住院时间均短于对照组(P<0.05);研究组并发症总发生率低于对照组(P<0.05)。结论慢性泪囊炎患者采用鼻内镜下鼻腔泪囊造口术治疗效果显著,并发症较少,安全性较高,值得临床推广应用。