Testing fidelity to a new psychological intervention for family members of substance misusers during implementation in Italy

Providing treatment and help to family members of people with alcohol and drug problems is a new approach. In the UK, a new intervention—the ‘5‐Step Method’— has been developed, which has shown positive results in reducing family members' symptoms and improving their coping. This method has been utilized in Italy, also with positive results. This paper analyses 52 treatment reports compiled by the treating professionals, to examine how well the method has been introduced into the Italian sociocultural context. Information about the intervention from these treatment reports was grouped into categories by independent judges. These categories were analysed using univariate statistics, followed by multivariate dynamic analysis using STATIS, a multidimensional statistical methodology capable of analysing the temporal phenomenon (over the five sessions) in question. This methodology examined the resulting 3‐way matrix: cases, variables, and time. The analysis shows that the training was effective: the trained personnel did deliver the five steps and did do in each step what was suggested in the manual. It also suggests that some overall strategies, such as giving family members a plan and proposing up to five sessions with the family member are very helpful interventions. Suggestions for improving both the intervention, and for incorporating instruction in this method as part of initial professional training, are made.     

Once-weekly exenatide as a treatment for Type 2 diabetes

Type 2 diabetes mellitus is a progressive disease that requires pharmacologic treatment to prevent microvascular and macrovascular complications. As the disease progresses, most patients require combination therapy to achieve glucose control targets. Exenatide once weekly (EQW) is a glucagon-like peptide-1 receptor agonist approved in the United States in 2012 for use as a second-line agent to treat Type 2 diabetes mellitus. EQW has shown reductions in HbA1c and weight without causing an increased risk of hypoglycemia. This review will summarize the current clinical trial, observational study, and pharmacoeconomic analyses evaluating EQW and its impact on HbA1c and weight.     

Toward the elimination of lymphatic filariasis by 2020: treatment update and impact assessment for the endgame

Lymphatic filariasis (LF) is an important public health problem endemic in 73 countries, where it is a major cause of acute and chronic morbidity and a significant impediment to socioeconomic development. It is targeted for elimination by 2020, through preventive chemotherapy using albendazole in combination with either ivermectin or diethylcarbamazine citrate. Preventive chemotherapy enables the regular and coordinated administration of safe, single-dose medications delivered through mass drug administration (MDA). Many countries are now scaling down MDA activities after achieving 100% geographic coverage and instituting monitoring and evaluation procedures to establish the impact of several consecutive rounds of MDA and determine if transmission has been interrupted. At the same time, countries yet to initiate MDA for elimination of LF will adopt improved mapping and coverage assessment protocols to accelerate the efforts for achieving global elimination by 2020. This review provides an update on treatment for LF and describes the current global status of the elimination efforts, transmission control processes and strategies for measuring impact and continuing surveillance after MDA has ceased.     

心脏彩色多普勒超声对高血压性心脏病患者病情程度的评估价值

目的 探讨心脏彩色多普勒超声对高血压性心脏病患者病情程度的评估价值.方法 选取2018年9月至2019年10月深圳市龙岗区第二人民医院收治的高血压性心脏病患者40例分为观察组,同期选取健康者40例进行对照研究,分为对照组,所有入选对象均接受心脏彩色多普勒超声检查,对检查结果进行观察比较.结果 观察组射血分数、血流频谱E...     

围化疗期恶性肿瘤患者的营养状况分析

目的：运用简易营养评定法对围化疗期恶性肿瘤患者病人进行营养评估,以了解患者化疗前后营养不良变化,为营养支持治疗提供依据。方法：对恶性肿瘤患者化疗前后进行人体测量和相关的生化检查,用简易营养评定对其营养状况作综合评价,并对不同性别、病期之间的营养不良发生情况进行分析。结果：化疗后用淋巴细胞判断的营养不良发生率显著增高,Ⅳ期病人在营养不良发生率也明显增加。结论：恶性肿瘤患者化疗后以淋巴细胞判定的营养不良发生率增高,Ⅳ期病人的营养不良改变最为显著。     

Tei指数评价高血压病患者右心功能的研究

目的应用Tel指数评价高血压病患者右心功能，探讨其临床价值。方法将81例高血压病患者根据Ganau分型，采用脉冲多普勒显像技术，测量并计算右心Tei指数，与23例健康人右室Tei指数作对比。结果高血压组较正常对照组右心Tei指数增加，与（IRT＋ICT）显著正相关（r=0．89，P〈0．001），与ET及IRT有相关性（r=-0．70，0．77，P〈0.01），与ICT无明显相关性（r=0．36，P〉0．05）。结论Tel指数是一个敏感、简便、综合评价右心整体功能的指标。     

自动管电流调节技术在胸部低剂量CT筛查中的临床价值

目的 探讨16层螺旋CT自动管电流调节(ATCM)技术在胸部低剂量CT筛查中的临床价值.方法 94名常规体检人员分为两组:A组45名,扫描方案为固定噪声指数(NI)为14,应用ATCM技术自动调节管电流(20～200 mA);B组49名,扫描方案为固定管电流40 mAs.两名医师采用双盲法对肺尖、中肺、下肺图像进行图像质量评分(IQS),测量图像标准差(SD)值,记录加权CT剂量指数(CTDIw),并进行统计学分析.结果 肺尖、中肺、下肺SD值:A组为13.62±2.07、11.70±0.85、11.89±1.26,B组为17.20±2.66、11.29±2.32、12.82±2.49;IQS:A组为1.82±0.36、1.58±0.38、1.66±0.34,B组为2.30±0.47、1.67±0.42、1.74±0.48.在肺尖,A组的SD值和IQS低于B组(P＜0.05).A、B两组CTDIw比较:受检者体质量指数(BMI)≤27 kg/m2时,A、B两组差异无统计学意义;BMI＞27 kg/m2时,A组高于B组(P＜0.05).结论 胸部低剂量CT筛查中,应用ATCM技术可在更大的密度衰减范围和体质量较大的人群中得到更高质量的图像.     

2型糖尿病患者颈动脉粥样硬化与胰岛素抵抗的相关分析

目的探讨2型糖尿病患者颈动脉粥样硬化与胰岛素抵抗的相关性。方法将63例2型糖尿病患者分为血糖控制良好组30例（糖化血红蛋白≤7％）及控制不良组33例（糖化血红蛋白〉7％）;选取健康者35例为对照组。超声检查三组颈动脉内-中膜厚度（IMT）,观察斑块发生率。同时测量空腹血糖和空腹血清胰岛素,并计算胰岛素抵抗指数（HOMA—IR）。结果血糖控制不良组HOMA—IR、IMT及斑块发生率均高于血糖控制良好组（P〈0．05）,且IMT与空腹血糖、HOMA—IR呈正相关（r=0．624,r=0．458,P〈0．05）。结论2型糖尿病患者高HOMA—IR组较低HOMA—IR组颈动脉粥样硬化病变更明显。     

声脉冲辐射力弹性成像与生化S指数评定兔肝纤维化的实验研究

目的探讨声脉冲辐射力弹性成像(ARFI)技术与血清生化指标S指数在兔肝纤维化分期中的诊断价值。方法 32只家兔皮下注射5%硫代乙酰胺制备肝纤维化模型(实验组),8只家兔于颈背部皮下注射生理盐水(对照组)。于造模第4、8、12周末行ARFI和血清实验室检查,获取肝脏剪切波速度(SWV),计算S指数,取肝脏制作标本行病理肝纤维化分期,比较SWV与S指数在兔肝纤维化分期中的诊断价值。结果实验组中29只家兔造模成功,肝纤维化分期S1、S2、S3、S4期分别为10只、8只、7只、4只;另3只家兔肝脏严重炎症坏死而无纤维化。SWV与S指数均随着纤维化程度的加重而增大,各组间差异均有统计学意义(P﹤0.05);SWV较S指数与肝纤维化病理分期具有更显著的相关性(r=0.724、0.472,P﹤0.05);应用SWV和S指数诊断肝纤维化程度≥S1、≥S2、≥S3、S4对应的ROC曲线下面积分别为0.92、0.87、0.82、0.89和0.76、0.75、0.71、0.74。结论 ARFI较生化S指数能更准确地诊断兔肝纤维化程度。     

Tei指数结合声学定量技术评价肝硬化患者左室功能的价值

目的探讨Tei指数结合声学定量技术评价肝硬化患者左心功能的临床价值。方法肝硬化组患者40例,按照Child-Pugh分级分为A级、B级、C级,体检健康者30例为对照组,脉冲多普勒测量其左室Tei指数及左室射血分数(EF),应用Qlab软件测量左房充盈分数(AFF)、左室快速充盈期峰值率(PRFA)。结果肝硬化患者左室Tei指数及AFF高于对照组,PRFA低于对照组(P0.05),其中Child C级患者Tei指数和AFF高于Child A级,EF和PRFA低于Child A级(P0.05)。结论 Tei指数结合声学定量技术优于传统方法评价肝硬化患者左心功能,为临床提供了检测肝硬化患者左室功能改变的新方法。