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41.
Mean Chhi Vun Tung Rathavy Mao Tang Eang Seng Sopheap Samreth Sovannarith Chhea Chhorvann Ly Vanthy Oum Sopheap Emily Welle Laurent Ferradini Chin Sedtha Sok Bunna Robert Verbruggen 《Journal of the International AIDS Society》2014,17(1)
Introduction
In the mid-1990s, Cambodia faced one of the fastest growing HIV epidemics in Asia. For its achievement in reversing this trend, and achieving universal access to HIV treatment, the country received a United Nations millennium development goal award in 2010. This article reviews Cambodia’s response to HIV over the past two decades and discusses its current efforts towards elimination of new HIV infections.Methods
A literature review of published and unpublished documents, including programme data and presentations, was conducted.Results and discussion
Cambodia classifies its response to one of the most serious HIV epidemics in Asia into three phases. In Phase I (1991–2000), when adult HIV prevalence peaked at 1.7% and incidence exceeded 20,000 cases, a nationwide HIV prevention programme targeted brothel-based sex work. Voluntary confidential counselling and testing and home-based care were introduced, and peer support groups of people living with HIV emerged. Phase II (2001–2011) observed a steady decline in adult prevalence to 0.8% and incidence to 1600 cases by 2011, and was characterized by: expanding antiretroviral treatment (coverage reaching more than 80%) and continuum of care; linking with tuberculosis and maternal and child health services; accelerated prevention among key populations, including entertainment establishment-based sex workers, men having sex with men, transgender persons, and people who inject drugs; engagement of health workers to deliver quality services; and strengthening health service delivery systems. The third phase (2012–2020) aims to attain zero new infections by 2020 through: sharpening responses to key populations at higher risk; maximizing access to community and facility-based testing and retention in prevention and care; and accelerating the transition from vertical approaches to linked/integrated approaches.Conclusions
Cambodia has tailored its prevention strategy to its own epidemic, established systematic linkages across different services and communities, and achieved nearly universal coverage of HIV services nationwide. Still, the programme must continually (re)prioritize the most effective and efficient interventions, strengthen synergies between programmes, contribute to health system strengthening, and increase domestic funding so that the gains of the previous two decades are sustained, and the goal of zero new infections is reached. 相似文献42.
Hao‐Wen Chuang Jia‐Bin Liao Huang‐Chou Chang Jyh‐Seng Wang Shong‐Ling Lin Pin‐Pen Hsieh 《Pathology international》2014,64(7):352-357
We report the case of a 68‐year‐old man with a newly defined rare entity of a peripheral pulmonary tumor, consisting of a nodular papillary lesion with papillary structures containing ciliated columnar and goblet cells, as well as floating tumor cells in the mucin pool. The conspicuous mucin pool was observed to be mimicking colloid adenocarcinoma in a low‐power view, particularly in a frozen section slide. We originally reported it as an adenocarcinoma during intraoperative consultation. Immunohistochemically, the tumor cells exhibited a similar immunophenotype to pulmonary adenocarcinoma, except for the presence of focal ciliated and basaloid cells, which we found using CK5/6 and P63 immunostaining. No KRAS or EGFR mutation was found. We revised the diagnosis to that of a ciliated muconodular papillary tumor (CMPT). Four years after a wedge resection, the patient remained free of tumors. Although the malignant potential of CMPT cannot be ignored, a wedge resection with a safe margin might be a treatment option for CMPT patients. 相似文献
43.
Seng JS Schrot JA van De Ven C Liberzon I 《Journal of psychosomatic obstetrics and gynaecology》2007,28(4):209-217
INTRODUCTION: The purpose of this study was to redress weaknesses in past studies of a psychogenic etiology for hyperemesis gravidarum (HG) by (1) estimating from a known population what proportion of HG cases also have psychiatric diagnoses, (2) determining if psychiatric disorder preceded HG, and (3) re-considering whether non-pregnancy somatic conditions also precede HG. METHODS: We analyzed insurance data for all 11,016 members who gave birth to singletons in 2000-2004, 208 of whom had HG. RESULTS: Prevalence of HG was 1.8% overall, 3.8% with one psychiatric diagnosis, 5.8% with >1 psychiatric diagnosis. One in 10 HG cases had pre-pregnancy depression, anxiety, or substance abuse diagnoses. One in five HG cases had either a psychiatric or a somatic condition (e.g., chronic pelvic pain, dysmenorrhea) diagnosis prior to pregnancy. Pre-pregnancy psychiatric diagnosis doubled the adjusted odds of HG. Combined psychiatric and somatic diagnoses quadrupled the adjusted odds of HG. DISCUSSION: Vomiting is a non-specific sign that may have multiple etiologies. For 10-20% of HG sufferers, vomiting may be a physical comorbidity of a psychiatric condition occurring in the context of pregnancy. Psychobiological research with HG cases with past or current psychiatric diagnoses is needed to consider plausible mechanisms. 相似文献
44.
Hui Jun Lim Adrian Kah Heng Chiow Lip Seng Lee Siong San Tan Brian KP Goh Ye Xin Koh Chung Yip Chan Ser Yee Lee 《Singapore medical journal》2021,62(4):182
INTRODUCTIONFluorescence imaging (FI) with indocyanine green (ICG) is increasingly implemented as an intraoperative navigation tool in hepatobiliary surgery to identify hepatic tumours. This is useful in minimally invasive hepatectomy, where gross inspection and palpation are limited. This study aimed to evaluate the feasibility, safety and optimal timing of using ICG for tumour localisation in patients undergoing hepatic resection.METHODSFrom 2015 to 2018, a prospective multicentre study was conducted to evaluate feasibility and safety of ICG in tumour localisation following preoperative administration of ICG either on Day 0–3 or Day 4–7.RESULTSAmong 32 patients, a total of 46 lesions were resected: 23 were hepatocellular carcinomas (HCCs), 12 were colorectal liver metastases (CRLM) and 11 were benign lesions. ICG FI identified 38 (82.6%) lesions prior to resection. The majority of HCCs were homogeneous fluorescing lesions (56.6%), while CLRM were homogeneous (41.7%) or rim-enhancing (33.3%). The majority (75.0%) of the lesions not detected by ICG FI were in cirrhotic livers. Most (84.1%) of ICG-positive lesions detected were < 1 cm deep, and half of the lesions ≥ 1 cm in depth were not detected. In cirrhotic patients with malignant lesions, those given ICG on preoperative Day 0−3 and Day 4−7 had detection rates of 66.7% and 91.7%, respectively. There were no adverse events.CONCLUSIONICG FI is a safe and feasible method to assist tumour localisation in liver surgery. Different tumours appear to display characteristic fluorescent patterns. There may be no disadvantage of administering ICG closer to the operative date if it is more convenient, except in patients with liver cirrhosis. 相似文献
45.
Oon Hoe Teoh Tan Pih Lin Marieke Abrahamse-Berkeveld Antoinette Winokan Yap Seng Chong Fabian Yap Maya Marintcheva-Petrova Eline M. van der Beek Lynette P. Shek 《Nutrients》2022,14(3)
Lipids are essential for healthy infant growth and development. The structural complexity of lipids in human milk is not present in infant milk formula (IF). A concept IF was developed mimicking more closely the structure and composition of human milk fat globules. The current study evaluates whether a concept IF with large, milk phospholipid-coated lipid droplets (mode diameter 3 to 5 μm) is equivalent to standard IF with regard to growth adequacy and safety in healthy, term Asian infants. In this randomized, double-blind, controlled trial, infants were randomized after parents decided to introduce formula. Infants received a standard IF with (Control) or without the specific prebiotic mixture scGOS/lcFOS (9:1 ratio; Control w/o prebiotics), or a Concept IF with large, milk phospholipid-coated lipid droplets and the prebiotic mixture. A group of 67 breastfed infants served as a reference. As a priori defined, only those infants who were fully intervention formula-fed ≤28 days of age were included in the equivalence analysis (Control n = 29; Control w/o prebiotics n = 28; Concept n = 35, per-protocol population). Primary outcome was daily weight gain during the first four months of life, with the difference between the Concept and Control as the key comparison of interest. Additionally, adverse events, growth and tolerance parameters were evaluated. Equivalence of daily weight gain was demonstrated between the Concept and Control group after additional correction for ethnicity and birthweight (difference in estimated means of 0.1 g/d, 90%CI [−2.30, 2.47]; equivalence margin +/− 3 g/d). No clinically relevant group differences were observed in secondary growth outcomes, tolerance outcomes or number, severity or relatedness of adverse events. This study corroborates that an infant formula with large, milk phospholipid-coated lipid droplets supports adequate growth and is well tolerated and safe for use in healthy infants. 相似文献
46.
Our objective was to address the gap in knowledge about the extent to which perinatal mental health and risk behaviors are associated with childhood and adult experiences of abuse that arises because of barriers to screening and disclosure about past and current abuse. Survey data from an ongoing study of the effects of posttraumatic stress on childbearing were used to describe four groups of nulliparous women: those with no abuse history, adult abuse only, childhood abuse only, and abuse that occurred during both periods. The rates of abuse history disclosure were higher in the research context than in the clinical settings. Mental health morbidity and risk behaviors occurred in a dose-response pattern with cumulative abuse exposure. Rates of current posttraumatic stress disorder ranged from 4.1% among those never abused to 11.4% (adult only), 16.0% (childhood only), and 39.2% (both periods). Women abused during both periods also were more likely to be using tobacco (21.5%) and drugs (16.5%) during pregnancy. We conclude that mental health and behavioral risk sequelae affect a significant portion of both childhood and adult abuse survivors in prenatal care. The integration into the maternity setting of existing evidence-based interventions for the mental health and behavioral sequelae of abuse is needed. 相似文献
47.
The objective of this study was to assess the validity and observed effect size of a new instrument, the Optimality Index-United States (OI-US), for use in perinatal clinical research. Using a large, hospital-based, midwifery service clinical database that included complete obstetric data for 3425 women, we examined discriminant validity and the effects of two different scoring methods used with the OI-US. Discriminant validity was confirmed by comparing OI scores for women who remained low risk and did not require physician involvement in their care (OI score mean = 84%; standard deviation [SD] = 8%) compared to those whose condition changed to require physician involvement in their care (mean = 71%; SD = 10%; P < .001). Two methods of scoring the OI-US were compared, finding no significant difference and suggesting that the types of data available and the research question can drive this decision. Finally, effect size was calculated by two methods: Cohen's d (-1.4) and the effect size correlation (r = -0.548), the latter of which corresponds to a d of -1.3, both resulting in a similarly large effect size estimation. The OI-US is a new instrument that shows promise for use in perinatal clinical research, particularly when assessing more subtle clinical differences in outcomes between study groups. 相似文献
48.
目的 探讨CT对儿童肾上腺神经母细胞瘤和肾母细胞瘤的诊断与鉴别诊断的价值。方法 分析经手术病理证实的 36例肾上腺神经母细胞瘤及 32例肾母细胞瘤的CT表现。结果 肾上腺神经母细胞瘤为肾外肿块 ,肾脏呈受压改变 ,钙化发生率高 ;肾母细胞瘤为肾内肿块 ,“边缘征”较具特征。结论 CT是诊断与鉴别诊断肾上腺神经母细胞瘤和肾母细胞瘤最有价值的检查方法之一 ,可为术前定性诊断 ,确定治疗方案和估计预后提供重要依据。 相似文献
49.
目的 探讨早期乳腺癌保乳综合治疗的原则及近期疗效。方法 我院 1997年 1月至 2 0 0 2年 12月 2 8例临床Ⅰ、ⅡA 期乳腺癌患者施行保乳手术 ,即局部乳腺切除 +同侧腋淋巴结清扫 ;术后 3周辅助全乳放疗 ;病理切片腋淋巴结有转移者予CMF方案化疗 ;ER阳性者服用TAM 3~ 5年。结果 平均随访 3 6个月 ,2 6例无瘤生存、乳房外形良好 ;2例术后 18个月及 2 4个月局部复发行乳癌根治手术。结论 早期乳腺癌保乳手术与根治术效果相近且能保持乳房良好外形 ,必将成为早期乳腺癌的首选手术方法 相似文献
50.