General vaccination willingness and current vaccination status in relation to clinical and psychological variables in patients with multiple sclerosis

BackgroundInfections can have a significant impact on morbidity and mortality in multiple sclerosis (MS) patients. Therefore, vaccinations are of immense importance. If vaccination willingness is to be increased, possible influencing factors should be identified. The aim of the present study was to investigate the status of active immunisation in MS patients in association with sociodemographic, clinical-neurological, psychopathological and personality variables using the NEO-Five Factor Inventory, the Temperament and Character Inventory-Revised and the Hospital Anxiety and Depression Scale.MethodFour hundred and four MS patients from two German neurological hospitals were examined for their vaccination attitudes, in detail, the general willingness to vaccinate and the current vaccination status of mumps, measles and rubella (MMR) as well as tetanus and influenza. We also looked at the current level of disability in relation to the current vaccination status, as well as possible associated personality and psychopathological variables.ResultsPatients with a complete MMR vaccination status were significantly younger and those with a complete influenza vaccination status were significantly older than those with related incomplete vaccination status. Tetanus vaccination status completeness did not differ depending on age and did not show substantial association with personality scores. However, influenza vaccination completeness was associated with differences in personality and psychopathological variables; extraversion, openness, novelty seeking, harm avoidance and anxiety. A reported general vaccination willingness was significantly correlated with the current completeness of tetanus and influenza vaccinations. Novelty seeking, persistence, extraversion, agreeableness, conscientiousness and neuroticism were found associated with an increased vaccination willingness. Anxiety and depression were not related to general vaccination willingness.ConclusionsNo specific personality trait could be defined on its own in relation to general vaccination willingness or complete vaccination status. Younger patients should be made more aware of influenza vaccination. Reasons for rather low vaccination rates need to be further investigated.     

Enlarged high frequency oscillations of the median nerve somatosensory evoked potential and survival in amyotrophic lateral sclerosis

ObjectiveA large N20 and P25 of the median nerve somatosensory evoked potential (SEP) predicts short survival in amyotrophic lateral sclerosis (ALS). We investigated whether high frequency oscillations (HFOs) over N20 are enlarged and associated with survival in ALS.MethodsA total of 145 patients with ALS and 57 healthy subjects were studied. We recorded the median nerve SEP and measured the onset-to-peak amplitude of N20 (N20o-p), and peak-to-peak amplitude between N20 and P25 (N20p-P25p). We obtained early and late HFO potentials by filtering SEP between 500 and 1 kHz, and measured the peak-to-peak amplitude. We followed up patients until endpoints (death or tracheostomy) and analyzed the relationship between SEP or HFO amplitudes and survival using a Cox analysis.ResultsPatients showed larger N20o-p, N20p-P25p, and early and late HFO amplitudes than the control values. N20p-P25p was associated with survival periods (p = 0.0004), while early and late HFO amplitudes showed no significant association with survival (p = 0.4307, and p = 0.6858, respectively).ConclusionsThe HFO amplitude in ALS is increased, but does not predict survival.SignificanceThe enlarged HFOs in ALS might be a compensatory phenomenon to the hyperexcitability of the sensory cortex pyramidal neurons.     

Does frequent residential mobility in early years affect the uptake and timeliness of routine immunisations? An anonymised cohort study

BackgroundThere are conflicting findings regarding the impact of residential mobility on immunisation status. Our aim was to determine whether there was any association between residential mobility and take up of immunisations and whether they were delayed in administration.MethodsWe carried out a cohort analysis of children born in Wales, UK. Uptake and time of immunisation were collected electronically. We defined frequent movers as those who had moved: 2 or more times in the period prior to the final scheduled on-time date (4 months) for 5 in 1 vaccinations; and 3 or more times in the period prior to the final scheduled on-time date (12 months) for MMR, pneumococcal and meningitis C vaccinations. We defined immunisations due at 2–4 months delayed if they had not been given by age 1; and those due at 12–13 months as delayed if they had not been given by age 2.ResultsUptake rates of routine immunisations and whether they were given within the specified timeframe were high for both groups. There was no increased risk (odds ratios (95% confidence intervals) between frequent movers compared to non-movers for the uptake of: primary MMR 1.08 (0.88–1.32); booster Meningitis C 1.65 (0.93–2.92); booster pneumococcal 1.60 (0.59–4.31); primary 5 in 1 1.28 (0.92–1.78); and timeliness: primary MMR 0.92 (0.79–1.07); booster Meningitis C 1.26 (0.77–2.07); booster pneumococcal 1.69 (0.23–12.14); and primary 5 in 1 1.04 (0.88–1.23).DiscussionFindings suggest that children who move home frequently are not adversely affected in terms of the uptake of immunisations and whether they were given within a specified timeframe. Both were high and may reflect proactive behaviour in the primary healthcare setting to meet Government coverage rates for immunisation.     

Restless legs syndrome in children and adolescents with attention-deficit/hyperactivity disorder: prevalence,mimic conditions,risk factors,and association with functional impairment

ObjectivesTo determine the prevalence of restless legs syndrome (RLS) and RLS-mimic conditions, the risk factors for RLS, and whether RLS contributes to functional impairment in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).MethodsADHD children and adolescents were prospectively studied at the outpatient psychiatric clinic. A trained registered nurse used the 2012 Revised International Restless Legs Syndrome Study Group diagnostic criteria to diagnose RLS. Sociodemographic data and medical records were reviewed. Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) Thai version was used to identify association between RLS and 6 domains of function [family, school (learning), school (behavior), life skills, child self-concept, social activities, and risky activities].ResultsA total of 217 patients were included. Of those, 23 (11%) patients met the criteria for RLS, and 49 (23%) had RLS-mimic conditions. Those conditions included myalgia (30/49), habitual foot tapping (23/49), positional discomfort (20/49), leg ulcer/bruise (1/49), and arthralgia/arthritis (1/49). Binary logistic regression revealed first-degree relative having RLS symptom to be significantly associated with RLS in study patients (OR: 5.06, p < 0.01). Multivariate linear regression showed RLS to be independently associated with school (behavior) (Β = 1.18, p = 0.05) and life skills (Β = 2.36, p = 0.05) impairment.ConclusionsRLS was found to be common in ADHD children and adolescents. RLS-mimic conditions were found in two-thirds of patients who previously met 4 essential RLS criteria. First-degree relative with RLS symptom was associated with RLS, and RLS was associated with functional impairment in the life skills and school (behavior) domains.     

中医健康状态辨识模式的研究现状与展望

健康状态的辨识是把握健康的前提。当前学界已存在专家辨识模式、标准辨识模式、数字辨识模式、智能辨识模式以及微观辨识模式等。联合多种辨识方法,构建健康状态辨识体系,形成常态与动态结合、主观与客观结合、人机互参的中医健康状态个体化辨识方法是研究的趋势所在。文章对未来的研究方向进行展望,探讨了多元辨识模式、远程辨识模式、终身辨识模式、自动辨识模式的思路方法,以期促进全民健康事业,助力"健康中国"战略。     

台州市功能性消化不良的流行病学现状调查及影响因素分析

目的 探讨台州市功能性消化不良的流行病学现状及影响因素。方法 回顾性选取2020年1月至2022年2月浙江省台州医院收治的功能性消化不良患者200例，统计患者的一般资料，分析该病的流行病学现状，对功能性消化不良的影响因素进行单因素分析，然后将差异有统计学意义的因素再进一步纳入多因素Logistic回归分析。结果 200例功能性消化不良患者中，女性发病率高于男性；30~60岁年龄段群体，患病率最高；存在暴饮暴食、喜食烫食、挑食、多食酸制品、未准时进食、常食宵夜、睡眠时间<6h、有药物过敏史、有功能性消化不良家族史、存在便秘情况者的患病率均高于未存在以上情况者，差异均有统计学意义（P<0.05）。多因素Logistic回归分析显示，性别、年龄、暴饮暴食、喜食烫食、挑食、多食酸制品、未准时进食、宵夜摄取情况、每天睡眠时间、药物过敏史、家族史、便秘是该病患病率升高的主要影响因素。结论 性别、年龄、暴饮暴食、喜食烫食、挑食、酸制品、未准时进食情况、宵夜摄取情况、每天睡眠时间、药物过敏史、家族史、便秘是功能性消化不良的主要影响因素。     

互联网形势下医院离退休干部管理工作探索

当前我国科技技术进一步提升,国民生活水平也在不断地进步,对于医院离退休干部管理服务的要求也越来越高。对于医院的工作来说,处理好医院的退离休老干部是一项十分重要的工作,所以医院工作管理人员需要提高对于离退休老干部管理工作的重视。而在传统意义下医院离退休干部的管理服务,存在着较多的问题,而当前在互联网的形势下却能够实现更加具有科学化、合理化的服务。通过创新服务理念,对于管理方式进行改革,可以有效地改善当前对于医院离退休干部的管理服务水平,青年团员可以自行组成相应的志愿者,加强对于退休老人的关心,了解老干部在生活以及学习中出现的问题,并且采取有效的措施进行解决。本文通过以阐述我国当前离退休干部管理工作的现状作为切入点,进行分析探究,进一步提出互联网模式下提高我国医院离退休干部管理的对应措施。     

Patient Functional Status as an Indication for Primary Total Hip Arthroplasty: A Systematic Review and Meta-Analysis

BackgroundThe number of total hip arthroplasties performed per year is increasing for reasons not fully explained by a growing and aging population. The purpose of this study was to determine the role of patient functional status as an indication for surgery and determine if patients are undergoing surgery at a better functional status than in the past.MethodsA systematic review and meta-analysis of the MEDLINE, EMBASE, and Cochrane databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Functional status was assessed using the 36-Item Short-Form Health Survey’s Physical Component Summary score. Only primary procedures were included; revisions were excluded. Articles were screened by 2 independent reviewers with conflicts resolved with a third reviewer. Meta-regression analysis was performed to determine the effect of time, patient age, and gender. Subgroup analysis was performed to compare geographic regions.ResultsA total of 1504 articles were identified. Data from 172 groups representing 18,644 patients recruited from 1990 to 2013 and identified from 107 articles were included. The mean preoperative Physical Component Summary score was 31.2 (95% confidence interval 30.5-31.9) with a 95% prediction interval of 22.6-39.8. The variance across studies was statistically significant (P = .000) with 97.25% true variance. Year of enrollment, age, and the percentage of females were not found to have any significant effect. There were no differences between countries.ConclusionPatients are undergoing total hip arthroplasty at a similar preoperative physical functional status as in the past. Patient age, gender, and location do not influence the functional status at which patients are indicated for surgery.     

The critical role of the inferior frontal cortex in establishing a prediction model for generating subsequent mismatch negativity (MMN): A TMS-EEG study

BackgroundThe prediction violation account of automatic or pre-attentive change detection assumed that the inferior frontal cortex (IFC) is involved in establishing a prediction model for detecting unexpected changes. Evidence supporting the IFC’s contribution to prediction model is mainly based on the Mismatch Negativity (MMN) to deviants violating predictions that are established based on the frequently presented standard events. However, deviant detection involves processes, such as events comparison, other than prediction model establishment.ObjectiveThe current study investigated the critical role of the IFC in establishing a prediction model during standards processing for subsequent deviant detection.MethodsTranscranial Magnetic Stimulation (TMS) was applied at the IFC to disrupt the processing of the initial 2 or 5 standards of a 3-, 6-, or 9-standard train, while the MMN responses to pitch deviant presented after the standard trains were recorded and compared.ResultsAn abolishment of MMN was only observed when TMS was delivered to the IFC at the initial 2 standards of the 3-standard train, but not at the initial 5 standards, or when TMS at the vertex or TMS sound recording was applied. The MMNs were also preserved when IFC TMS, vertex TMS, or TMS sound recording was applied at the initial 2 or 5 standards of longer trains.ConclusionThe IFC plays a critical role in processing the initial standards of a short standard train for subsequent deviant detection. This result is consistent with the prediction violation account that the IFC is important for establishing the prediction model.