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21.
William A. Monaco John E. Crews Anh Thy H. Nguyen Areeb Arif 《Journal of the American Medical Directors Association》2021,22(6):1156-1161
ObjectivesTo examine data from Delaware nursing homes to determine prevalence of age-related eye diseases (AREDs), vision impairment, and blindness and to compare the findings with the results of 11 US investigations of vision and eye health in nursing homes.DesignThis is a cross-sectional, retrospective study of nursing home patients.Setting and ParticipantsTwenty nursing homes in Delaware participated in the study, yielding comprehensive eye examination records for 2019 study participants.MethodsSummary statistics and regression analyses.ResultsThe overall prevalence of vision impairment or blindness was 63.8% and was above 60% for each age, sex, and race category. Prevalence of vision impairment or blindness was 68.4% among patients with cataracts, 69.4% among patients with macular degeneration, 70.5% among patients with glaucoma, and 68.4% among patients with diabetic retinopathy. Prevalence of blindness was 14.1%. Among patients with AREDs, prevalence of blindness ranged from 15.0% for patients with cataracts to 22.6% for patients with diabetic retinopathy. When compared with other investigations, we found wide variation in vision and eye factors reported and wide variation in the prevalence of those factors. Only 4 studies diagnosed both AREDs and visual function. Seven studies reported AREDs, and 7 reported vision impairment and/or blindness. Vision impairment or blindness ranged from 29% to 67%; cataract ranged from 32% to 83%; macular degeneration ranged from 4.6% to 70.7%. Glaucoma ranged from 5.3% to 41.4%; diabetic retinopathy ranged from 1.7% to 3.1%.Conclusions and ImplicationsComprehensive eye examinations showed that vision impairment and blindness affected 63.8% of nursing home residents. Compared with other studies, there was a wide range of vision factors reported and wide variation in the prevalence of vision impairment or blindness and AREDs. This investigation suggests the importance of eye care in nursing homes and the importance of reporting standard vision and eye health factors to inform policy and practice. 相似文献
22.
Emmanuel Nwachuku Yizhi Shan Prabhu Senthil-Kumar Todd Braun Ryan Shadis Orlando kirton Thai Q. Vu 《American journal of surgery》2021,221(1):240-242
BackgroundClostridioides difficile infection (CDI) is traditionally taught to be an antibiotic associated diarrheal infection. This diagnosis is based on the presence of clinical symptoms (usually defined as more than 3 watery, loose or unformed stool within 24 h) coupled with a diagnostic test. There is now a new presentation of CDI, including progression to toxic megacolon, in patients without diarrhea.MethodsWe report a case series of 9 surgical patients from a single institution who developed CDI without preceding diarrhea.ResultAll 9 patients had CDI with positive laboratory testing for C. difficile toxin. They, however, presented with a lack of or minimal bowel movements. Six patients had rapid development of abdominal distention, 1 patient had a single episode of watery stool in 3 days, while the other 2 patients presented with constipation. Seven patients received stool softeners, suppositories and/or enemas for presumed constipation. Four patients had a mild course of infection and were successfully treated medically. The other 5 patients developed toxic megacolon, and eventually required total abdominal colectomy. Out of the 5 patients that required total colectomy, 2 expired.ConclusionCDI must be suspected in patients who rapidly develop abdominal distention, vague abdominal complaints or change in bowel function even in the absence of diarrhea, especially if coupled with multi-system organ failure. 相似文献
23.
24.
Nguyen Minh Hai Nguyen Dang Dung Dinh Cong Pho Vu Tung Son Vu Ngoc Hoan Phan Tan Dan Bui Dang The Anh La Huong Giang Pham Ngoc Hung 《Vaccine》2021,39(7):1140-1147
BackgroundROTAVAC® is derived from human 116E rotavirus (RV) neonatal strain. In this study, we evaluated the immunogenicity, safety and reactogenicity of ROTAVAC® in Vietnam.MethodWe conducted a phase IV clinical trial in healthy infants aged 6–8 weeks using the complete regimen of ROTAVAC® with three doses. Serum anti-RV IgA was measured by enzyme-linked immunosorbent assay to assess the geometric mean concentration in infants who received the complete regimen of the vaccine.ResultsA total of 360 participants were enrolled in this clinical trial. The mean age ± standard deviation at enrollment was 6.9 ± 0.6 weeks. The anti-RV IgA titer was 4.01 ± 3.74 mg/ml pre-vaccination and substantially increased to 29.27 ± 80.64 mg/ml post-vaccination. The value of logIgA significantly increased (p = 0.003) from 0.28 ± 0.79 to 1.03 ± 0.54. The proportion of participants with equal to and greater than 3-fold and 4-fold shifts in pre- to post-vaccination antibody titer (IgA) were 55.4% and 48.3%, respectively. No adverse events or serious adverse events were recorded immediately within 30 min after the administration of each dose. The most common adverse events within 14 days after each visit were fever, unusual crying and irritability. Other adverse events occurred at a low rate, and no case of intussusception was noted.ConclusionsThe complete regimen of ROTAVAC® demonstrated an immunological response with clinically acceptable safety profile. Post-completion of this study, ROTAVAC® is now a WHO-prequalified vaccine and available in Vietnam. 相似文献
25.
Conclusion Malgré des défaillances occasionnelles, les observations détaillées de l'ensemble des 45 cas permettent de dire qu'il n'y a pas de relation entre les départs et la fréquence des consommations d'héoÏne antérieures au départ, telle que le montrent les analyses chimiques.Les 45 départs sont-ils des échecs? Si 1'on prend comme critères de réussite l'indépendance d'un individu par rapport à la drogue, son indépendance affective et son indépendance économique, l'absence de la relation précédente suggère qu'un certain nombre d'entre eux pourrait bien etre sorti de la dependance de la drogue au moment de leur départ, pour autant qu'ils puissent satisfaire par la suite leurs besoins économique et affectif. Le nombre d' échecs tendrait ainsi à diminuer.Sur le plan opposé, les 25 cas ayant franchi toutes les phases du programme de cure sont-ils des réussites? La difficulté de les suivre régulièrement sur une longe période incite à la réserve. Le chiffre de 36% est relativement optimiste. Ces résultats tempèrent les conclusions énoncées dans le rapport Schmidt et Delachaux (2) mais lui apportent en mÊme temps une base de justification plus solide.
Non medical treatment of heroÏn addicts and chemical analysis as an element of appreciation
Summary Group psychotherapy programme is applied in a heroÏn addiction treatment center in conjunction with a systematic planning of chemical analyses along the course of the cure. The addicts live under inspected regime. At best 25 out of 70 cases (36 %) conclude the programme with occasional and non repetitive failures. The question of their follow-up beyond their treatment period arises in order to better evaluate their retrieval.No relationship was observed between individuals who had quit the programme and the frequency of heroÏn consumptions during the time they were under treatment.
Nichtmedizinische Behandlung von Heroinomanen und chemische Analyse als Bewertungselement
Zusammenfassung In einer Anstalt zur Behandlung der Heroinsucht wurde ein gruppenpsychotherapeutisches Programm zusammen mit einer systematischen Plannung chemischer Analysen während der Behandlung durchgeführt. Die Süchtigen leben unter Uberwachung. Höchstens 25 aus 70 Fällen (36%) schlossen das Programm mit gelegentlichen und nichtwiederholten Rückfällen ab. Ihre Uberwachung nach der Behandlungsperiode als Bewertungselement ihrer Rehabilitation bleibt noch offen. Ein Zusammenhang zwischen den vom Programm abtretenden Personen und der Häufigkeit ihres Heroinverbrauches während der Behandlungsperiode konnte nicht festgestellt werden.相似文献
26.
Compromised kidney graft rejection response in Vervet monkeys after withdrawal of immunosuppressants tacrolimus and sirolimus 总被引:2,自引:0,他引:2
Chen H Peng J Luo H Loubeau M Wan X Xu D Qi S Vu MD Daloze P Fitzsimmons WE Bekersky I Peets J Sehgal SN Wu J 《Transplantation》2000,69(8):1555-1561
BACKGROUND: In nonprimates, organ allografts are often not rejected after withdrawal of immunosuppression. In this study, we examined whether such a phenomenon also occurs in primates. METHODS: Vervet monkeys were transplanted with renal allografts and treated for 60 days with tacrolimus, or tacrolimus plus sirolimus. The drugs were totally withdrawn on day 61. The survival of the monkeys was monitored, and their response to donor- or third party-derived alloantigens was examined in vivo and in vitro. RESULTS: The majority (80-100%) of the grafts survived for at least additional 30 days with no signs of acute rejection. The compromised rejection is donor-specific, because recipient monkeys failed to reject a donor-derived skin graft, but a third-party skin graft was rejected. In vitro mixed lymphocyte reaction and interleukin-2 production in the mixed lymphocyte reaction between the recipients and their donors or between the recipients and a third party had no discernable patterns, and thus did not reflect the in vivo status of the immune system. Although the recipients could not reject the graft acutely after drug withdrawal, the kidney grafts and the donor-derived skin grafts had pathological findings of chronic rejection. CONCLUSIONS: The rejection response of the monkeys to an established graft after withdrawal of immunosuppression is compromised. The compromised rejection is specific and is not due to a permanent alteration of the immune system by the initial drug treatment. The allografts are not inert but have low levels of interaction with the recipient immune system. 相似文献
27.
Stacy M Plum Arthur D Hanson Kirk M Volker Hong A Vu B Kim Lee Sim William E Fogler Anne H Fortier 《Clinical cancer research》2003,9(12):4619-4626
PURPOSE: Current combination treatment strategies in malignancy are designed to evaluate the use of cytotoxic drugs and antiangiogenic agents. Endostatin, a fragment of collagen XVIII, specifically inhibits proliferation, migration, and differentiation of endothelial cells in vitro as well as angiogenesis and tumor progression in in vivo models. In this study, we determine the antitumor effect of rhEndostatin administered alone or in combination with Adriamycin against established orthotopic murine mammary carcinoma. EXPERIMENTAL DESIGN: Mice bearing orthotopically established DA-3 mammary adenocarcinoma tumors received varying doses of rhEndostatin alone and in combination with Adriamycin to assess tumor growth inhibition. Additional studies of this in vivo combination included a determination of Adriamycin-induced cardiotoxicity and in vitro effects on human umbilical vein endothelial cell proliferation and cord formation. RESULTS: For single-agent activity, optimal tumor growth inhibition was observed after s.c. administration of 50 mg/kg/day rhEndostatin or 5 mg/kg Adriamycin injected i.v. every 4 days. Combination of Adriamycin with optimal or suboptimal doses of rhEndostatin resulted in synergistic inhibition of DA-3 tumor growth. Importantly, unlike other antiangiogenic agents, rhEndostatin did not exacerbate the cardiotoxicity of Adriamycin. The synergistic interaction between rhEndostatin and Adriamycin was also observed in vitro for inhibition of human umbilical vein endothelial cell proliferation and inhibition of cord formation. CONCLUSIONS: These data suggest that the synergy observed with rhEndostatin in combination with Adriamycin is exerted at the level of the endothelial cell and can result in enhanced tumor growth inhibition. The potential benefit of Adriamycin used in combination with rhEndostatin is being considered for clinical evaluation. 相似文献
28.
Sheila A Prindiville Tim Byers Fred R Hirsch Wilbur A Franklin York E Miller Kieu O Vu Holly J Wolf Anna E Barón Kenneth R Shroyer Chan Zeng Tim C Kennedy Paul A Bunn 《Cancer epidemiology, biomarkers & prevention》2003,12(10):987-993
Individuals with cytological atypia in sputum may be at increased risk for lung cancer. We conducted a longitudinal analysis of the association between lung cancer incidence and cytological atypia in sputum samples collected prospectively from an ongoing cohort of adults at high risk for lung cancer. Cohort members had a smoking history of > or = 30 pack-years and chronic obstructive pulmonary disease documented by pulmonary airflow testing. Sputum samples collected at baseline and periodically thereafter were examined by standard cytological methods. From the cohort of 2,006 people, there were 83 incident lung cancers over 4,469 person-years of observation. At baseline, the association between personal and behavioral characteristics, and sputum cytological atypia was assessed by multiple logistic regression. The association between sputum cytological atypia and incident lung cancer was then assessed by hazard ratios using proportional hazards regression analysis, adjusting for potential confounding factors. Cytological atypia graded as moderate or worse was associated with continuing cigarette smoking (adjusted odds ratio, 2.5; 95% confidence interval, 1.5-4.1), and with lower levels of intake of fruits and vegetables (P for trend = 0.04). Atypia was not associated with several other factors, including the degree of airflow obstruction, the use of vitamin supplements, nonsteroidal anti-inflammatory drugs, or metered-dose steroid inhalers. Incident lung cancer was increased among those with moderate or worse cytological atypia (adjusted hazards ratio, 2.8; 95% confidence interval, 1.4-5.5). This association was not confounded by other risk factors. We conclude that in this high-risk cohort, cytological atypia is associated with continuing smoking and low intake of fruits and vegetables, but that independent of these and other factors, the risk of incident lung cancer is increased among those with moderate or worse grades of cytological atypia in their sputum. 相似文献
29.
Striatal trophic activity is reduced in the aged rat brain 总被引:2,自引:0,他引:2
Ling ZD Collier TJ Sortwell CE Lipton JW Vu TQ Robie HC Carvey PM 《Brain research》2000,856(1-2):301-309
Our previous studies demonstrated that the survival of a mesencephalic graft was reduced in aged animals suggesting an age-related decline in target-derived neurotrophic activity. We tested this hypothesis by examining dopamine (DA) and trophic activities from the striatum of intact or unilateral 6-hydroxydopamine (6-OHDA) lesioned rats of increasing age. Fisher 344 rats were 4, 12, 18, and 23 months old (m.o.) at sacrifice. Half the animals had received unilateral 6-OHDA lesions of the mesostriatal DA pathway 8 weeks earlier. Striatal tissue punches were analyzed for DA, homovanillic acid (HVA), and DA activity (HVA/DA) using HPLC. The remainder of the striatal tissue was homogenized to generate tissue extracts which were added to E14.5 ventral mesencephalic cultures to test trophic activity. In the non-lesioned animals, striatal DA was reduced and striatal DA activity was increased in the 18 and 23 m.o. animals relative to the 4 and 12 m.o. animals. Striatal trophic activity was inversely related to age. In the lesioned animals, striatal DA ipsilateral to 6-OHDA infusion was below detection limits while the contralateral striatum exhibited age-related changes in DA similar to those seen in the non-lesioned animals. In 4 m.o. lesioned rats, striatal trophic activity ipsilateral to 6-OHDA infusion was elevated by 26% relative to the contralateral side. The ipsi/contra-lateral differences in striatal trophic activity were reduced in 12 m.o. animals and absent in the 18 and 23 m.o. groups. These data suggest that advancing age is associated with a reduction in striatal DA as well as trophic activity. Moreover, the aged striatum loses its ability to biochemically and trophically compensate for DA reduction and therefore may represent a more challenging environment for the survival, growth, and function of a fetal graft. 相似文献
30.
目的 探讨选择性动脉栓塞对鼻咽部纤维血管瘤手术的应用价值。方法 对12例鼻咽部纤维血管瘤行术前栓塞,供血动脉主要为颈外动脉系统,以其分支颌内动脉多见;部分有颈内动脉系统参与供血。结果 12例病人于栓塞术后2~3d行手术切除术,术中出血减少,肿瘤易于剥离。结论 鼻咽部纤维血管瘤术前栓塞疗效肯定,应作为术前常规准备。 相似文献