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To determine the incidence of transfusion-associated human immunodeficiency virus (HIV) infection after routine screening of donated blood, a pilot study estimated the pretransfusion prevalence of HIV infection among blood product recipients in San Francisco. Among the 911 nonduplicate pretransfusion specimens from recipients without a clinical history of acquired immune deficiency syndrome (AIDS) or AIDS-related complex (ARC), the overall prevalence of antibody to HIV was 2.9 percent (5.2% among males and 0.6% among females; p = 0.00002). If recipients in specifically defined or possible high-risk groups (n = 348) were excluded, a seropositivity rate of 1.8 percent (10/563) was detected, with all the positives occurring in men (10/242, 4.1%) and none in women (0/321, 0%). This demonstrated prevalence of HIV infection among blood product recipients in San Francisco before transfusion was substantially higher than the known 0.02 to 0.04 percent prevalence in the donor population. Therefore, the population of women without known risk for AIDS is the best in which to assess the risk of HIV infection in patients who are currently receiving seronegative blood transfusions. 相似文献
73.
目的:观察胸腰段椎弓根CT测量在椎弓根螺钉内固定中的作用,寻找一种个体化椎弓根螺钉置入的方法。方法:选择1999-02/2006-03河北工程大学附属医院收治的T12和/或L1段骨折患者59例,行螺旋CT检查及图像三维重建,重建结束后,得到胸腰段标本的三维图像,通过旋转和切割进行图像处理并测量,模拟出T11~L2的椎弓根形态,根据CT测量椎弓根的实际投照点进行调整,即横断面上椎弓根轴线与矢状位上椎弓根轴线的交点,在确定进钉点时选择下关节突为参照物,选用合适直径的螺钉进行植钉,植入螺钉后,连接棒或板系统。结果:262个椎弓根行植钉术,242个完全在椎弓根内,仅有20个螺钉穿透椎弓根皮质。术后平均随访16.1个月,均无临床并发症的发生,Frankel平均增加1.4级。术后有2例患者出现断钉(3枚),1例患者出现断棒,所植入的螺钉与机体生物相容性好,无不良反应的发生。结论:利用三维CT测量的数据辅助,严格按照个体化的椎弓根的轴线方向植钉,在置钉时应考虑到螺钉本身直径的因素,可以提高植钉的成功率。 相似文献
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Tore Gude Per Vaglum Tor Anvik Anders Bærheim Ole Bernt Fasmer Hilde Grimstad Per Hjortdahl Are Holen Tone Nordøy Hilde Eide 《Patient education and counseling》2009
Objective
To test whether young physicians improve their communication skills between graduating from medical school and completing clinical internship, and to explore contributing background and/or internship factors.Methods
Norwegian medical students graduating June 2004 were invited to take part in a videotaped standardized patient interview February 2004. Of the 111 students who originally participated, 62 completed a second interview February 2006. Observed communication skills were assessed with the Arizona Communication Interview Rating Scale (ACIR).Results
The level of communication skills increased significantly during the period for participants overall; and for females but not males. General social skills reached significantly higher levels than specific professional skills, both types of skill improving during the study. Independent predictors were working in local hospitals, learning atmosphere and low stress.At school completion, 50% reached a level defined as ‘advanced beginner’. Towards the end of the internship, 58% reached ‘capable’ and 27% ‘competent’ levels of communication skills.Conclusions
Female physicians improved most in communication skills, the gender difference being multivariate mediated through low stress levels and learning atmosphere. The findings support the division of communication skills into general social and specific professional skills.Practice implications
The relatively low proportion of young physicians, especially males, developing the capability to practise independently at internship completion indicates a need for more effective training in communication skills, during both medical school and internship. 相似文献78.
G Zaidi RP Sahu L Zhang G George N Bhavani N Shah V Bhatia A Bhansali G Jevalikar RV Jayakumar GS Eisenbarth E Bhatia 《Clinical genetics》2009,76(5):441-448
Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare recessive disorder resulting from mutations in the autoimmune regulator ( AIRE ) gene. There is no information on AIRE mutations in Indians. In a cross-sectional study, nine patients (eight families), from four referral hospitals in India, were studied for AIRE mutations by direct sequencing. We screened for new mutations in 150 controls by allele-specific PCR. The patients had 1–7 known components of APECED. Three patients had unusual manifestations: presentation with type 1 diabetes; chronic sinusitis and otitis media; and facial dysmorphism. All patients carried homozygous, probably recessive, AIRE mutations. Two unrelated patients from a small in-bred community (Vanika Vaisya) in south India carried an unreported missense mutation, p.V80G, in the N-terminal caspase recruitment domain. Another unique mutation, p.C302X, resulting in a truncated protein with deletion of both zinc-finger domains, was detected in a patient from Gujarat. Neither mutation was detected in controls. Other mutations, previously described in Caucasians, were: 13 base pair deletion (p.C322fsX372) in 4 (38%), and Finn-major (p.R257X) and p.R139X (Sardinian) mutation in one subject each. In conclusion, in this first series of APECED in Indians, we detected AIRE mutations previously reported in Caucasians, as well as unique mutations. Of these, p.V80G is possibly an ancestral mutation in an in-bred community. 相似文献
79.
Silvio ST Tafuri Domenico DM Martinelli Giovanni GC Caputi Annamaria AA Arbore Cinzia CG Germinario Rosa RP Prato 《BMC health services research》2009,9(1):100-5
Background
Mandatory vaccination has contributed to the success of immunisation programmes but voluntary vaccination allows people to be responsible for their own health. There are benefits from both policies and the arguments between them remain subject to debate within and without the scientific community, both nationally and internationally. The aim of this study is to assess the opinions of those who actually work in the Vaccination Service. 相似文献80.
Maria CLG Santos P Suzanne Hart Mukundhan Ramaswami Cláudia M Kanno Thomas C Hart Sergio RP Line 《Head & face medicine》2007,3(1):1-7