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Patients with Laryngeal Disorders Who Undergone Microlaryngeal Surgery at The Dr. Soetomo General Hospital Surabaya 在泗水Soetomo综合医院接受喉显微手术的喉疾病患者
Q4 Medicine Pub Date : 2023-03-13 DOI: 10.31584/jhsmr.2023939
Yohanes Dimas Pamungkas Priyambodo, Diar Mia Ardani, R. F. Perdana
Objective: To describe laryngeal abnormalities undergoing microlaryngeal surgery (MLS).  Material and Methods: A retrospective analytical study by examining the central medical record and electronic medical record of patients with laryngeal disorders in the otorhinolaryngology head and neck surgery (ORL-HNS) Outpatient Unit and the Teratai ORL-HNS Surgery Inpatient Care Unit at Dr. Soetomo General Hospital, Surabaya, from January 1 until December 31, 2019, utilizing the chi-square test followed by the Wald test.  Results: The number of patient visits from January 1 until December 31, 2019, amounted to 80 patients, most of whom were male and belonged to the 19-60 age group. The histopathology results of patients with neoplasms indicated moderately differentiated squamous cell carcinoma, while the same procedure applied to patients without neoplasms mainly indicated vocal nodules. In this case, the most used technique was a biopsy. Patients with smoking risk factors amounted to 38, while those without smoking risk factors amounted to 42.  Conclusion: MLS is used as a means of diagnosis and therapy, including cases of benign and malignant neoplasms.  
目的:描述接受喉显微外科手术(MLS)的喉部异常。材料和方法:一项回顾性分析研究,通过检查2019年1月1日至12月31日在泗水Soetomo综合医院耳鼻咽喉头颈外科门诊部和Teratai耳鼻咽喉外科住院部的喉部疾病患者的中心病历和电子病历,利用卡方检验然后是瓦尔德检验。结果:从2019年1月1日到12月31日,共有80名患者就诊,其中大多数是男性,属于19-60岁年龄组。有肿瘤的患者的组织病理学结果显示为中分化鳞状细胞癌,而同样的程序适用于无肿瘤的患者,主要显示为声带结节。在这种情况下,最常用的技术是活组织检查。有吸烟危险因素的患者达38人,无吸烟危险因素者达42人。结论:MLS可作为诊断和治疗手段,包括良性和恶性肿瘤。
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引用次数: 0
Disparities in Stress Coping Strategies among High School Students, in Bangkok, with Various Sexual Orientations and Gender Identities 曼谷不同性取向和性别认同高中生压力应对策略的差异
Q4 Medicine Pub Date : 2023-03-10 DOI: 10.31584/jhsmr.2023938
Nikhanif Radenahmad, Tikumporn Hosiri, Tidarat Puranachaikere, Kanthip Thongchoi, Prapim Engkananuvat
Objective: To ascertain any relationship between coping strategies, sexual orientation and gender diversity in regard to high school students in Bangkok, and to examine coping strategies among sexual and gender minority youths. Material and Methods: This cross-sectional survey included 600 students across Bangkok, Thailand. Participants completed an online questionnaire, consisting of demographic data and the Adolescent Coping Scale (Thai version). Descriptive statistics, the Mann-Whitney U test, and the Kruskal-Wallis test were used for data analysis (p-value≤0.05). Results: The participants included 301 males (50.2%), and 299 females (49.8%), with a mean age of 16.6. The sample identified as 83.7% cisgender, 16.3% non-cisgender (transgender, non-conforming, questioning/unspecified, and others), 64.8% heterosexual, and 35.2% non-heterosexual (homosexual, bisexual, asexual, pansexual, questioning/unspecified, and others). Females used more non-productive coping strategies than males (p-value=0.001), non-cisgender youths used more non-productive coping than cisgender youths (p-value<0.001), and non-heterosexual youths used more non-productive coping than heterosexual youth (p-value<0.001). Coping strategies mostly used by sexual and gender minority male youths were worrying, ignoring the problem, and wishful thinking, while coping strategies most used by sexual and gender minority female youths were worrying, not coping, and keeping to one’s self. Conclusion: Differences in regards to the sex assigned at birth, gender identity, and sexual orientation had a statistically significant correlation with different coping strategies, specifically in sexual and gender minority youths who used nonproductive coping strategies.   
目的:了解曼谷高中生的应对策略、性取向和性别多样性之间的关系,并研究性少数群体和性别少数群体青年的应对策略。材料和方法:这项横断面调查包括泰国曼谷的600名学生。参与者完成了一份在线问卷,其中包括人口统计数据和青少年应对量表(泰语版)。数据分析采用描述性统计、Mann-Whitney U检验和Kruskal-Wallis检验(p值≤0.05)。结果:参与者包括301名男性(50.2%)和299名女性(49.8%),平均年龄16.6岁。样本中83.7%为顺性别,16.3%为非顺性别(跨性别、不合规、质疑/未指明等),64.8%为异性恋,35.2%为非异性恋(同性恋、双性恋、无性恋、泛性恋、质疑/不指明等)。女性比男性使用更多的非生产性应对策略(p值=0.001),非顺性别青年比顺性别青年使用更多的无生产性应对(p值<0.001),而非异性恋青年比异性恋青年使用更多无生产性应付(p值p<0.001)。主要由性和性别少数男性青年使用的应对策略令人担忧,忽视了这个问题,一厢情愿,而性少数群体和性别少数群体女青年最常用的应对策略是担忧、不应对和保持自我。结论:出生性别、性别认同和性取向的差异与不同的应对策略具有统计学意义,特别是在使用非生产性应对策略的性少数群体和性别少数群体青年中。
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引用次数: 1
Quality of Sleep and Associating Factors among the Elderly with Urinary Incontinence 老年尿失禁患者的睡眠质量及相关因素
Q4 Medicine Pub Date : 2023-03-09 DOI: 10.31584/jhsmr.2023937
Triradchayakorn Kaewpunya, N. Howteerakul, S. Siri, N. Suwannapong, Pokket Sirisreetreerux
Objective: This study aimed to assess the prevalence of poor quality of sleep, and its associating factors among Thai elderly with urinary incontinence (UI), in Chiang Rai province. Material and Methods: Study samples from 419 individuals with UI, aged ≥60 years and living in Chiang Rai province were taken. Multi-stage random sampling was used to recruit study participants. Thai versions of the International Consultation on Incontinence Questionnaire-Short Form (TICIQ-UI SF) and the Pittsburg Sleep Quality Index (TPSQI) were used as data collection instruments. Results: Overall, 84.2% of participants had poor quality of sleep (TPSQI >5); with the mean TPSQI score being 8.4±3.16. Approximately 21.5%, 69.2%, and 9.3% had severe, moderate, and mild UI, respectively. Multiple logistic regression analysis revealed that being female (OR=2.77; 95% confidence interval (CI), 1.47-5.24); having a moderate severity of UI (OR=3.63; 95% CI, 1.10-11.96); being a current smoker (OR=6.84; 95% CI, 2.09-22.33); monthly income of <5,000 Baht (<167 USD) (OR=4.27; 95% CI, 1.33-13.73); being a current alcohol consumer (OR=3.04; 95% CI, 1.47-6.28) and being depressed (OR=3.91; 95% CI, 1.44-10.56) were significantly associated with poor quality of sleep. Conclusion: The prevalence of poor quality of sleep among the elderly with UI was rather high. The combined effects of several risk factors caused the elderly with moderate UI to have a poor quality of sleep. Healthcare personnel should regularly conduct screening for quality of sleep, UI, and depression and provide sleep health education to the elderly with UI, especially the elderly with depression, smokers, and alcohol consumers. 
目的:本研究旨在评估泰国清莱省老年尿失禁(UI)患者睡眠质量差的患病率及其相关因素。材料与方法:选取清莱省419例年龄≥60岁的尿失禁患者作为研究样本。采用多阶段随机抽样方法招募研究参与者。使用泰国版本的国际尿失禁咨询问卷简表(TICIQ-UI SF)和匹兹堡睡眠质量指数(TPSQI)作为数据收集工具。结果:总体而言,84.2%的参与者睡眠质量较差(TPSQI bb0.5);TPSQI平均评分为8.4±3.16。约21.5%,69.2%和9.3%分别为重度,中度和轻度UI。多元logistic回归分析显示,女性(OR=2.77;95%置信区间(CI), 1.47-5.24);患有中度重症UI (OR=3.63;95% ci, 1.10-11.96);目前吸烟(OR=6.84;95% ci, 2.09-22.33);月收入<5,000泰铢(<167美元)(OR=4.27;95% ci, 1.33-13.73);目前是饮酒者(OR=3.04;95% CI, 1.47-6.28)和抑郁(OR=3.91;95% CI, 1.44-10.56)与睡眠质量差显著相关。结论:老年尿失禁患者睡眠质量较差的发生率较高。多种危险因素的综合作用导致中度尿失尿的老年人睡眠质量较差。医护人员应定期进行睡眠质量、尿失禁和抑郁症筛查,并对尿失禁老年人,特别是抑郁症老年人、吸烟者和饮酒者进行睡眠健康教育。
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引用次数: 0
Application of Longitudinal Data the Multilevel Models Approach on Diabetes Mellitus 纵向数据在糖尿病多水平模型研究中的应用
Q4 Medicine Pub Date : 2023-03-08 DOI: 10.31584/jhsmr.2023936
W. Moges, Tenaw Endalamaw
Objective: Diabetes mellitus is a metabolic disorder that develops over time and affects the cardiovascular system, eyes, kidneys, nerves, and blood sugar levels. The aim of this investigation was to determine the prevalence of diabetic mellitus patients, identify the associating risk factors using a multilevel longitudinal model, and understand the multilevel model changes for the level-1 and level-2 models.  Material and Methods: We examined such types of scenarios using multilevel longitudinal models such as the simple random intercept multilevel model, the random coefficient model, and the null model.  Results: There were 248 individuals with diabetes mellitus enrolled in the study for follow-up measurements over 4 time points, among these 248 individuals, 211 had complete data for all four time points. Based on the intraclass correlation coefficient, much of the variability (88.35%) in diabetes mellitus patients was accounted for by the follow-up time in this study, whereas 11.65% of the variability could not be accounted for by the follow-up time. Moreover, the data analysis suggested that sex had a significant effect on diabetes mellitus patients with the progression of time.  Conclusion: Based on the results of our study, sex, baseline fasting and educational status had a significant effect on diabetes mellitus patients over time. The educational status of diabetes mellitus patients was found to have a significant effect throughout the follow-up time; this shows that when treating diabetes mellitus patients, the physician should beware of the nature of the disease and how to management diabetes requires a high level of awareness and motivation on part of the patients regarding self-care.
目的:糖尿病是一种随时间发展的代谢紊乱,影响心血管系统、眼睛、肾脏、神经和血糖水平。本研究的目的是利用多水平纵向模型确定糖尿病患者的患病率,识别相关危险因素,并了解1级和2级模型的多水平模型变化。材料和方法:我们使用多层纵向模型(如简单随机截距多层模型、随机系数模型和零模型)来检查这些类型的场景。结果:共有248例糖尿病患者入组进行了4个时间点的随访测量,其中211例患者的4个时间点数据完整。从类内相关系数来看,本研究中糖尿病患者的大部分变异性(88.35%)可以被随访时间所解释,而11.65%的变异性不能被随访时间所解释。此外,数据分析表明,随着时间的推移,性别对糖尿病患者有显著影响。结论:根据我们的研究结果,性别、基线禁食和教育程度对糖尿病患者有显著的影响。糖尿病患者的受教育程度对整个随访时间有显著影响;这表明,在治疗糖尿病患者时,医生应注意疾病的性质,如何管理糖尿病需要患者对自我保健的高度认识和动机。
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引用次数: 0
Dose Response Curves of Plasma Concentration 50 of Propofol Target-Controlled Infusion for Supraglottic Airway Devices: A Randomized Controlled Trial 用于声门上气道装置的丙泊酚靶向控制输注的血浆浓度50的剂量反应曲线:一项随机对照试验
Q4 Medicine Pub Date : 2023-03-01 DOI: 10.31584/jhsmr.2023935
Nalinee Kovitwanawong, Napipada Tangcharoenwathanakul, M. Oofuvong, Maliwan Oearsakul, Nichanun Pichayanukul
Objective: We aimed to determine the plasma concentration 50 (CP50) of propofol target controlled infusion (TCI) for successful insertion of four types of supraglottic airway devices (SGD). Material and Methods: This prospective parallel randomized controlled, double blinded, superiority trial was conducted in June 2012 following approval by the Ethics Committee of the Faculty of Medicine, Prince of Songkla University, Thailand. Effect-site concentrations (Ce) of propofol TCI were determined by the modified Dixon’s up-and-down method. After equilibration was established between the plasma and effect-site concentrations, a SupremeTM, ProSealTM(control groups), I-gelTM or Laryngeal Tube Suction IITM devices were inserted. The CP50 was determined by dose response logistic curves presented as means and 95% confidence intervals (CI). The General Estimating Equation was used to determine factors associated with hemodynamic changes. Results: The Ces of TCI propofol requirements in the SupremeTM, ProSealTM, I-gelTM and Laryngeal Tube Suction IITM groups were 5.8, 4.8, 5.6, and 5.8 μg/ml, respectively (effect size [95% CI]: 0.22 [0.06, 0.51], p-value 0.036). The CP50 [95% CIs] in the SupremeTM, ProSealTM, I-gelTM and Laryngeal Tube Suction IITM groups were 5.8 [-0.01, 11.6], 4.9 [3.3, 6.5], 5.7 [5.0, 6.3] and 5.5 [4.7, 6.4] μg/ml, respectively. Heart rates and systolic blood pressure were significantly higher in the Laryngeal Tube Suction IITM group than in the ProSealTM (p-value<0.01) and I-gelTMgroups (p-value<0.01 Conclusion: The ProSealTM and I-gelTM are preferred over the SupremeTM and Laryngeal Tube Suction IITM devices due to the lower CP50 and hemodynamic changes.  
目的:测定成功插入四种类型的声门上气道装置(SGD)的丙泊酚靶控输注(TCI)的血浆浓度50(CP50)。材料和方法:这项前瞻性平行随机对照、双盲、优越性试验于2012年6月在泰国宋克拉王子大学医学院伦理委员会批准后进行。采用改良的Dixon上下法测定丙泊酚TCI的作用部位浓度(Ce)。在血浆和作用位点浓度之间建立平衡后,插入SupremeTM、ProSealTM(对照组)、I-gelTM或喉管抽吸IITM装置。CP50通过以平均值和95%置信区间(CI)表示的剂量-反应逻辑曲线来确定。一般估算方程用于确定与血液动力学变化相关的因素。结果:SupremeTM、ProSealTM、I-gelTM和喉导管抽吸IITM组的TCI丙泊酚需求量分别为5.8、4.8、5.6和5.8μg/ml(效应大小[95%CI]:0.22[0.06,0.51],p值0.036),5.7[5.0,6.3]和5.5[4.7,6.4]μg/ml。喉导管抽吸IITM组的心率和收缩压显著高于ProSealTM组(p值<0.01)和I-gelTM组(p值<0.01结论:由于CP50和血液动力学变化较低,ProSealTM/I-gelTM优于SupremeTM和喉导管抽吸II TM装置。
{"title":"Dose Response Curves of Plasma Concentration 50 of Propofol Target-Controlled Infusion for Supraglottic Airway Devices: A Randomized Controlled Trial","authors":"Nalinee Kovitwanawong, Napipada Tangcharoenwathanakul, M. Oofuvong, Maliwan Oearsakul, Nichanun Pichayanukul","doi":"10.31584/jhsmr.2023935","DOIUrl":"https://doi.org/10.31584/jhsmr.2023935","url":null,"abstract":"Objective: We aimed to determine the plasma concentration 50 (CP50) of propofol target controlled infusion (TCI) for successful insertion of four types of supraglottic airway devices (SGD). Material and Methods: This prospective parallel randomized controlled, double blinded, superiority trial was conducted in June 2012 following approval by the Ethics Committee of the Faculty of Medicine, Prince of Songkla University, Thailand. Effect-site concentrations (Ce) of propofol TCI were determined by the modified Dixon’s up-and-down method. After equilibration was established between the plasma and effect-site concentrations, a SupremeTM, ProSealTM(control groups), I-gelTM or Laryngeal Tube Suction IITM devices were inserted. The CP50 was determined by dose response logistic curves presented as means and 95% confidence intervals (CI). The General Estimating Equation was used to determine factors associated with hemodynamic changes. Results: The Ces of TCI propofol requirements in the SupremeTM, ProSealTM, I-gelTM and Laryngeal Tube Suction IITM groups were 5.8, 4.8, 5.6, and 5.8 μg/ml, respectively (effect size [95% CI]: 0.22 [0.06, 0.51], p-value 0.036). The CP50 [95% CIs] in the SupremeTM, ProSealTM, I-gelTM and Laryngeal Tube Suction IITM groups were 5.8 [-0.01, 11.6], 4.9 [3.3, 6.5], 5.7 [5.0, 6.3] and 5.5 [4.7, 6.4] μg/ml, respectively. Heart rates and systolic blood pressure were significantly higher in the Laryngeal Tube Suction IITM group than in the ProSealTM (p-value<0.01) and I-gelTMgroups (p-value<0.01 Conclusion: The ProSealTM and I-gelTM are preferred over the SupremeTM and Laryngeal Tube Suction IITM devices due to the lower CP50 and hemodynamic changes.  ","PeriodicalId":36211,"journal":{"name":"Journal of Health Science and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45198918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Impact of Gender on Mortality and Symptomatic Intracerebral Hemorrhage in Acute Ischemic Stroke Patients After Intravenous Recombinant Tissue Plasminogen Activator (rt-PA) 性别对急性缺血性脑卒中患者静脉注射重组组织型纤溶酶原激活剂(rt-PA)后死亡率和症状性脑出血的影响
Q4 Medicine Pub Date : 2023-02-23 DOI: 10.31584/jhsmr.2023934
T. Mitsungnern, Saowaluck Inchanta, K. Kongbunkiat, S. Imoun, P. Kotruchin
Objective: The characteristics and risk factors of stroke differ between men and women. Women have a lower mortality but a higher disability rate after a stroke, as well as a higher rate of response to intravenous recombinant tissue plasminogen activator (rt-PA). However, the data regarding gender and outcomes after rt-PA in Asian populations is limited. Hence, this study aimed to make a comparison between men and women regarding mortality and symptomatic intracerebral hemorrhage (S-ICH) after rt-PA. Material and Methods: This was a retrospective cohort study conducted in a specialized stroke unit at a 1000-bed university hospital in Thailand. Adult patients, who were eligible for rt-PA, were recruited from the Stroke Fast Track Registry between 2015-2019. The clinical data and radiological results were collected and analyzed. Results: There was a total of 278 patients,138 of whom were men (49.6%). The men had a lower average age (63 vs. 68 years, p-value<0.001), had higher creatinine levels and higher diastolic blood pressure than the women (1.22±0.93 vs. 0.97±0.84 mg/dl, and 90±15 vs. 86±18 mmHg, all p-values<0.001). The mortality and S-ICH rates were comparable (2.3% vs. 5%, and 8.0% vs. 11.4%, respectively, all p-values>0.05). Having had a history of anti-platelet therapy was a strong risk factor for S-ICH in men (OR 6.43, 95% CI 1.39–29.69); whereas, age was significantly associated with mortality in women (OR 1.13, 95% CI 1.03–1.24). Conclusion: Men and women had similar rates of mortality and S-ICH after rt-PA. 
目的:脑卒中的特点和危险因素在男女之间存在差异。女性中风后死亡率较低,但致残率较高,对静脉注射重组组织纤溶酶原激活剂(rt-PA)的反应率较高。然而,关于亚洲人群rt-PA后的性别和结果的数据有限。因此,本研究旨在比较男性和女性在rt-PA后的死亡率和症状性脑出血(S-ICH)。材料和方法:这是一项回顾性队列研究,在泰国一所拥有1000张床位的大学医院的中风专科病房进行。2015-2019年间,从中风快速通道登记处招募了符合rt-PA条件的成年患者。收集并分析临床数据和放射学结果。结果:共有278名患者,其中138人为男性(49.6%)。男性平均年龄较低(63岁对68岁,p值0.05)。有抗血小板治疗史是男性S-ICH的一个重要危险因素(OR 6.43,95%CI 1.39-29.69);而年龄与女性死亡率显著相关(OR 1.13,95%CI 1.03-1.24)。结论:rt-PA后男性和女性的死亡率和S-ICH相似。
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引用次数: 0
In-vitro Antifungal Activities of Kombucha Tea Culture Supernatant Combined with Voriconazole against Vulvovaginal Candidiasis Clinical Isolates 康普茶培养上清液联合伏立康唑对外阴阴道念珠菌临床分离株的体外抗菌活性
Q4 Medicine Pub Date : 2023-02-23 DOI: 10.31584/jhsmr.2023933
R. Bassyouni, Fatma AboElnaga Ahmed, A. Ismaiel, A. Abdelmoneim, Haitham H Badran, M. E. El Zahry, R. Dwedar, A. Wegdan
Objective: To investigate the antifungal activity of voriconazole, with and without Kombucha tea culture, against Candida strains isolated from vulvovaginal candidiasis. Material and Methods: The study included 150 females, within child-bearing periods, complaining of valvovaginal candidiasis. Candida strains were isolated, and identified by conventional microbiological methods; and confirmed by Viteck-2 System. The sensitivity of the isolates to voriconazole was performed, via the Disc diffusion method. Resistant strains were then subjected to minimum inhibitory concentrations (MIC) investigation of voriconazole alone, and in combination with a Kombucha tea culture via the broth micro-dilution method in concentrations ranging from 0.0048 to 10 μg/ml. The ability of voriconazole, with and without Kombucha, to eradicate Candida biofilms were investigated using a crystal violet absorbance assay. Results: Eighty-nine strains were isolated. From these 60 isolates showed variable resistance patterns (57 were voriconazole resistant, and 3 had dose-dependent susceptability). Kombucha significantly decreased the MIC50 of voriconazole against all strains from 5 to 0.625 μg/ml (p-value<0.01); additionally, MIC90 were reduced from 10 to 1.25 μg/ml (p-value =0.000). Voriconazole at a concentration of 0.156 μg/ml succeeded in eradicating biofilms formed by 18 strains after adding a Kombucha tea supernatant versus zero strains when using Voriconazole alone. Conclusion: Kombucha Black tea cultures could be promising antifungal agents in the treatment of vulvovaginal candidiasis.
目的:研究伏立康唑对外阴阴道念珠菌分离株的抗真菌活性。材料和方法:这项研究包括150名育龄妇女,她们抱怨瓣膜阴道念珠菌感染。分离念珠菌菌株,并通过常规微生物学方法进行鉴定;并经Viteck-2系统确认。采用圆盘扩散法测定分离株对伏立康唑的敏感性。然后,通过肉汤微稀释法对抗性菌株单独使用伏立康唑,并与浓度在0.0048至10μg/ml范围内的康普茶培养物联合使用进行最低抑菌浓度(MIC)研究。采用结晶紫吸收法研究了伏立康唑在加入和不加入康普茶的情况下根除念珠菌生物膜的能力。结果:共分离到89株。这60个分离株表现出不同的耐药性模式(57个对伏立康唑耐药,3个具有剂量依赖性的可接受性)。康普茶显著降低伏立康唑对所有菌株的MIC50,从5μg/ml降至0.625μg/ml(p值<0.01);此外,MIC90从10μg/ml降低到1.25μg/ml(p值=0.000)。0.156μg/ml浓度的伏立康唑在添加康普茶上清液后成功地消除了18株菌株形成的生物膜,而单独使用伏立康唑时则为零株。结论:康普茶红茶培养物可作为治疗外阴阴道念珠菌感染的有前景的抗真菌药物。
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引用次数: 0
Development and Validation of a New Substance Use Disorder Screening Test Based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) 基于精神障碍诊断与统计手册(DSM-5)的新型物质使用障碍筛查试验的开发与验证
Q4 Medicine Pub Date : 2023-02-22 DOI: 10.31584/jhsmr.2023932
S. Saengduenchai, S. Nilaban, Tanya Singtho, A. Ranuwattananon, R. Kalayasiri
Objective: The lack of a screening tool for substance use disorders is a significant problem for health care workers for patient care and referral. This study aimed to develop a Substance Use Disorder Screening Test (SUDST) to enable accurate classification of the severity of substance use disorders based on the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), that can be used by health professionals in all settings for basic screening for individuals at risk of substance use disorder. Material and Methods: Following close study of the DSM-5, 11 questions were developed, which were then tested on 207 participants who were receiving treatment for the use of methamphetamines. The participants were interviewed with the SUDST, the Ministry of Public Health Version 2 (normally ‘V.2’) screening test for risk of substance use, and were clinically diagnosed by their attending psychiatrist. Results: The Cronbach’s alpha coefficient for SUDST was 0.79. The scores obtained from the SUDST were in high agreement with the V.2 and clinical diagnosis (p-value<0.001). Factor analysis showed three components of substance use disorder: 1) preoccupation and loss of control, 2) risky/harmful use, and 3) biopsychosocial aspects. Of the total possible score of 11, the cut-off points for identifying severe, moderate, and mild levels of risk were ≥7, 5-6, and 3-4, respectively, with sensitivity=72.7%-96.5% and specificity=61.9%-88.7%. Conclusion: The SUDST had high reliability and validity and could be used to detect patients at risk of substance use disorders.
目的:缺乏物质使用障碍的筛查工具是卫生保健工作者在患者护理和转诊方面面临的一个重大问题。本研究旨在开发一种物质使用障碍筛查测试(SUDST),以实现基于第五版精神疾病诊断与统计手册(DSM-5)的物质使用障碍严重程度的准确分类,可被卫生专业人员在所有环境中用于对有物质使用障碍风险的个体进行基本筛查。材料和方法:在对DSM-5进行深入研究后,开发了11个问题,然后对207名因使用甲基苯丙胺而接受治疗的参与者进行了测试。参与者接受了SUDST,即公共卫生部第2版(通常为' V.2 ')药物使用风险筛查试验的访谈,并由其主治精神病医生进行临床诊断。结果:SUDST的Cronbach’s alpha系数为0.79。SUDST评分与V.2和临床诊断高度一致(p值<0.001)。因子分析显示物质使用障碍的三个组成部分:1)专注和失去控制,2)危险/有害使用,3)生物心理社会方面。在11分的可能总分中,鉴定严重、中度和轻度风险水平的分界点分别为≥7、5-6和3-4,敏感性=72.7%-96.5%,特异性=61.9%-88.7%。结论:SUDST具有较高的信度和效度,可用于检测存在物质使用障碍风险的患者。
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引用次数: 4445
Effect of Masked Uncontrolled Hypertension on Perioperative Haemodynamic Response and Recurrent Adverse Cardiovascular Events among Patients Undergoing Major Noncardiac Surgery 未控制的高血压对非心脏大手术患者围手术期血流动力学反应和复发不良心血管事件的影响
Q4 Medicine Pub Date : 2023-02-20 DOI: 10.31584/jhsmr.2023931
Sirikarn Siripruekpong, A. Geater, S. Cheewatanakornkul
Objective: To compare masked uncontrolled hypertension (MUCH) (n=16) and adequately controlled hypertension (ACH) (n=21) patients regarding their haemodynamic response to induction, incision and extubation, and evaluate the risk of perioperative recurrent adverse cardiovascular events in a prospective observational study.  Material and Methods: After home blood pressure (BP) monitoring, patients were classified as MUCH or ACH using objective criteria. Perioperative haemodynamic parameters were monitored. Recurrent adverse event risks were evaluated using total-time and gap-time recurrent-event analysis.  Results: BP responses to induction were qualitatively similar in the two groups, but with an exaggerated response following incision and extubation in the MUCH group. Risks of recurrent hypertensive events were higher in MUCH than in ACH patients during the intraoperative and emergence periods, with hazard ratios [95% confidence intervals] of 2.10 [1.21, 3.64] and 4.73 [1.12, 19.89] from total-time models, and 1.84 [1.20, 2.84] and 5.91 [1.45, 24.11] from gap-time models; the risk of recurrent bradycardia was higher during emergence, 4.08 [1.22, 13.59] from total-time and 4.88 [1.77, 13.45] from gap-time models. In contrast, the risk of recurrent hypotension was significantly lower in the MUCH patients during induction.  Conclusion: Compared to ACH, MUCH patients were at increased risk of recurrent hypertensive events during the intraoperative and emergence periods, and of recurrent bradycardia during emergence.
目的:在一项前瞻性观察性研究中,比较掩饰性未控制高血压(MUCH)(n=16)和充分控制高血压(ACH)(n=21)患者对诱导、切开和拔管的血液动力学反应,并评估围手术期复发性心血管不良事件的风险。材料和方法:在家庭血压监测后,根据客观标准将患者分为MUCH或ACH。监测围手术期血流动力学参数。使用总时间和间隔时间复发事件分析评估复发不良事件风险。结果:两组对诱导的BP反应在质量上相似,但在MUCH组中,切开和拔管后的反应有所夸大。在术中和苏醒期,MUCH患者复发性高血压事件的风险高于ACH患者,总时间模型的风险比[95%置信区间]分别为2.10[1.21,3.64]和4.73[1.12,19.89],间隙时间模型的危险比分别为1.84[1.20,2.84]和5.91[1.45,24.11];苏醒期复发性心动过缓的风险更高,总时间为4.08[1.22,13.59],间隙时间模型为4.88[1.77,13.45]。相反,MUCH患者在诱导过程中复发性低血压的风险显著降低。结论:与ACH相比,MUCH患者在术中和苏醒期再次发生高血压事件的风险增加,在苏醒期再次出现心动过缓的风险增加。
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引用次数: 0
Correlation between the Clinical Course of CRMO Lesions and the Imaging Characteristics on Follow-up MRIs CRMO病变的临床过程与随访MRI影像学特征的相关性
Q4 Medicine Pub Date : 2023-02-17 DOI: 10.31584/jhsmr.2023929
Pattira Boonsri, Takeshi Fukada, L. J. Prahaspathiji, Min Huang
Objective: To evaluate the correlation between the clinical course of chronic recurrent multifocal osteomyelitis (CRMO) lesions and their imaging characteristics on follow-up MRIs. Material and Methods: Two musculoskeletal fellowship-trained radiologists retrospectively reviewed the initial and follow-up MRI images of 9 CRMO patients who were treated in our institution from 2008 to 2018. Evaluation of clinical course was based on symptomatology, lab results and physical examination and was compared to MRI findings, on follow-up MRIs. Results: Thirty-five CRMO lesions in 9 patients were identified. Patient’s ages ranged from 4 to 15 years with a mean age of 10 years (S.D.±3.22). Six of the 9 patients were female. Only 21 of 35 lesions had been longitudinally followed by MRI. Of the 39 follow-up MRI exams, there was clinical improvement 15 times, and 24 times there was no clinical improvement confirmed by the clinician. Three MRI features: 1) bone marrow edema (BME) size, 2) BME signal intensity and 3) periosteal edema, significantly correlated with the clinical course (p-value<0.001). When there was the improvement of all these three findings, the correlation with clinical improvement was high with 80% sensitivity and 100% specificity. The area under the receiver operator characteristic curve was 0.90 (95% confidence interval 0.795-1.005). Fourteen silent clinical lesions were also identified. Conclusion: Bone marrow edema and periosteal edema correlated best with the clinical course of CRMO patients on follow-up MRIs.
目的:评价慢性复发性多灶性骨髓炎(CRMO)病变的临床病程与其随访MRI影像学特征之间的相关性。材料和方法:两名受过肌肉骨骼研究金培训的放射科医生回顾性回顾了2008年至2018年在我们机构接受治疗的9名CRMO患者的初始和随访MRI图像。临床过程的评估基于症状、实验室结果和身体检查,并与MRI结果和随访MRI结果进行比较。结果:9例患者共发现35个CRMO病变。患者年龄在4-15岁之间,平均年龄为10岁(s.D.±3.22)。9名患者中有6名为女性。35个病灶中只有21个进行了MRI纵向随访。在39次随访的MRI检查中,有15次临床改善,24次没有得到临床医生证实的临床改善。三个MRI特征:1)骨髓水肿(BME)大小,2)BME信号强度和3)骨膜水肿,与临床病程显著相关(p值<0.001)。当这三个结果都有改善时,与临床改善的相关性很高,敏感性为80%,特异性为100%。受试者-操作者特征曲线下的面积为0.90(95%置信区间0.795-1.005)。还发现了14个无声临床病变。结论:骨髓水肿和骨膜水肿与CRMO患者的临床病程密切相关。
{"title":"Correlation between the Clinical Course of CRMO Lesions and the Imaging Characteristics on Follow-up MRIs","authors":"Pattira Boonsri, Takeshi Fukada, L. J. Prahaspathiji, Min Huang","doi":"10.31584/jhsmr.2023929","DOIUrl":"https://doi.org/10.31584/jhsmr.2023929","url":null,"abstract":"Objective: To evaluate the correlation between the clinical course of chronic recurrent multifocal osteomyelitis (CRMO) lesions and their imaging characteristics on follow-up MRIs. Material and Methods: Two musculoskeletal fellowship-trained radiologists retrospectively reviewed the initial and follow-up MRI images of 9 CRMO patients who were treated in our institution from 2008 to 2018. Evaluation of clinical course was based on symptomatology, lab results and physical examination and was compared to MRI findings, on follow-up MRIs. Results: Thirty-five CRMO lesions in 9 patients were identified. Patient’s ages ranged from 4 to 15 years with a mean age of 10 years (S.D.±3.22). Six of the 9 patients were female. Only 21 of 35 lesions had been longitudinally followed by MRI. Of the 39 follow-up MRI exams, there was clinical improvement 15 times, and 24 times there was no clinical improvement confirmed by the clinician. Three MRI features: 1) bone marrow edema (BME) size, 2) BME signal intensity and 3) periosteal edema, significantly correlated with the clinical course (p-value<0.001). When there was the improvement of all these three findings, the correlation with clinical improvement was high with 80% sensitivity and 100% specificity. The area under the receiver operator characteristic curve was 0.90 (95% confidence interval 0.795-1.005). Fourteen silent clinical lesions were also identified. Conclusion: Bone marrow edema and periosteal edema correlated best with the clinical course of CRMO patients on follow-up MRIs.","PeriodicalId":36211,"journal":{"name":"Journal of Health Science and Medical Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47748749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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