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Gallstones increase the risk of nonalcoholic fatty liver: A case-control study 胆结石会增加罹患非酒精性脂肪肝的风险:病例对照研究
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1002/hsr2.70068
Abdolreza Sheibani, Hamid Reihani, Ahmad shoja, Mohammad M. Gharibvand, Mohammad G. Hanafi

Background

Nonalcoholic fatty liver disease (NAFLD) and gallstones are generally seen together, and many of the risk factors for fatty liver and gallstones are common and similar. Therefore, this study aims to investigate the relationship between NAFLD and gallstones.

Methods

This case-control study was conducted in patients referred to Imam Khomeini and Golestan hospitals of Ahvaz University of Medical Sciences in 2023, whose ultrasound showed fatty liver. Patients who were diagnosed with NAFLD by ultrasound were considered as the case group, and patients who did not have diagnostic findings of fatty liver in ultrasound were considered as the control group. Finally, the information recorded in the checklists was statistically analyzed using SPSS version 26 (SPSS Inc.).

Results

Three hundred patients were included in our study, 150 as cases and 150 as controls. There was no significant difference between the groups in terms of gender and age (gender P-value: 0.817/age P-value: 0.102). A statistically significant relationship was found between obesity, diabetes mellitus (DM), the presence of gallstones, and NAFLD (weight p-value < 0.001/DM p-value < 0.001/gallstones P-value: 0.03). In addition, based on binary logistic regression analysis, the presence of gallstones increases the odds of NAFLD by 2.33 times (P-value: 0.035). Furthermore, having DM and increasing each BMI unit increases the odds of NAFLD by 16 times and 30%, respectively (BMI p-value < 0.001/DM p-value < 0.001).

Conclusion

Based on the results of our study, gallstones are an important risk factor for NAFLD. The possible mechanisms are the existence of common risk factors between gallstones and NAFLD and the reduction of motility and flow of bile in the bile ducts with the presence of gallstones.

背景:非酒精性脂肪肝(NAFLD)和胆结石通常会同时出现,而且脂肪肝和胆结石的许多危险因素是共同的、相似的。因此,本研究旨在探讨非酒精性脂肪肝与胆结石之间的关系:这项病例对照研究的对象是 2023 年转诊到阿瓦士医科大学伊玛目霍梅尼医院和戈勒斯坦医院的患者,这些患者的超声波检查结果显示他们患有脂肪肝。经超声波检查确诊为非酒精性脂肪肝的患者为病例组,超声波检查未发现脂肪肝的患者为对照组。最后,使用 SPSS 26 版(SPSS 公司)对核对表中记录的信息进行统计分析:研究共纳入 300 名患者,其中 150 人为病例组,150 人为对照组。两组患者在性别和年龄上无明显差异(性别 P 值:0.817/年龄 P 值:0.102)。肥胖、糖尿病(DM)、胆结石和非酒精性脂肪肝之间存在统计学意义上的明显关系(体重 P 值 P 值 P 值:0.03)。此外,根据二元逻辑回归分析,存在胆结石会使非酒精性脂肪肝的几率增加 2.33 倍(P 值:0.035)。此外,患有 DM 和 BMI 单位每增加一个,非酒精性脂肪肝的几率就会分别增加 16 倍和 30%(BMI p 值 p 值 结论):根据我们的研究结果,胆结石是非酒精性脂肪肝的一个重要风险因素。可能的机制是胆结石和非酒精性脂肪肝之间存在共同的风险因素,以及胆结石的存在降低了胆管中胆汁的流动性和流动量。
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引用次数: 0
Development and validation of the Fall Risk Assessment Scale for patients in rehabilitation hospitals: A methodological study 康复医院患者跌倒风险评估量表的开发与验证:方法学研究
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1002/hsr2.70040
Shoeleh Rahimi, Hamid Reza Khankeh, Abbas Ebadi, Batol Mohammadian, Narges Arsalani, Masoud Fallahi-Khoshknab, Nazila Akbarfahimi, Elham Loni

Background and Aims

Falling is a serious threat for patient safety in hospitals. This study aimed to identify the risk factors of fall amongst rehabilitation patients and to use them for developing and validating the Persian version of Fall Risk Assessment Scale (FRAS).

Methods

The current methodological study was conducted in two phases. In the first phase, based on the review of the literature and investigation of the medical records of 251 patients selected via purposive sampling, the risk factors of fall were extracted and the FRAS was developed accordingly. In the second phase, the face and content validities of the designed scale were determined by cognitive interview and Content Validity Index (CVI) and to evaluate the construct validity, known-groups comparison was performed. Its inter-rater reliability was analyzed using the weighted Kappa Coefficient (κ*). The study adhered to COSMIN guidelines.

Results

Fall was significantly associated with disease diagnosis, used medications, history of fall, cognitive impairments, and three items of the Functional Independence Measure (toilet transfer, bed transfer, and shoer transfer). The CVI of the scale was 0.94. The risk for falls group had a significantly higher perceived fall risk than the no risk for falls group, thus establishing known-group validity. Its weighted kappa coefficient was >0.85, its sensitivity was 73%, and its specificity was 82%.

Conclusion

The valid and reliable FRAS may accurately assess the level of Fall Risk patients in Rehabilitation wards, helping to predict fall during hospitalization. So, enabling the planning and implementation of effective caring interventions.

背景和目的:跌倒是对医院患者安全的严重威胁。本研究旨在确定康复患者跌倒的风险因素,并利用这些因素开发和验证波斯语版跌倒风险评估量表(FRAS):本研究分两个阶段进行。第一阶段,在查阅文献和调查通过有目的抽样选出的 251 名患者的病历的基础上,提取了跌倒风险因素,并据此编制了跌倒风险评估量表。在第二阶段,通过认知访谈和内容效度指数(CVI)确定了所设计量表的表面效度和内容效度,并进行了已知组比较以评估其构造效度。采用加权卡帕系数(κ*)分析了评分者之间的信度。研究遵循了 COSMIN 指南:跌倒与疾病诊断、使用的药物、跌倒史、认知障碍以及功能独立性测量的三个项目(如厕转移、床上转移和推鞋转移)明显相关。量表的 CVI 值为 0.94。有跌倒风险组的感知跌倒风险明显高于无跌倒风险组,从而确立了已知组的有效性。其加权卡帕系数大于 0.85,灵敏度为 73%,特异度为 82%:结论:有效可靠的跌倒风险评估系统可准确评估康复病房患者的跌倒风险水平,有助于预测住院期间的跌倒情况。因此,可帮助规划和实施有效的护理干预措施。
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引用次数: 0
A Thorough Navigation of miRNA's Blueprint in Crafting Cardiovascular Fate 全面了解 miRNA 在塑造心血管命运中的作用。
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1002/hsr2.70136
Abubakar Nazir, Olivier Uwishema, Sanobar Shariff, William Xochitun Gopar Franco, Noha El Masri, Nitsuh Dejene Ayele, Isabelle Munyangaju, Fatima Esam Alzain, Magda Wojtara

Introduction

Cardiovascular diseases contribute significantly to global morbidity and mortality. MicroRNAs are crucial in the development and progression of these diseases by regulating gene expression in various cells and tissues. Their roles in conditions like atherosclerosis, heart failure, myocardial infarction, and arrhythmias have been widely researched.

Materials and Methods

The present study provides an overview of existing evidence regarding miRNAs' role in cardiovascular disease pathogenesis. Furthermore, the study examines current state-of-the-art technologies used in the study of miRNAs in cardiovascular disease. As a final point, we examine how miRNAs may serve as disease biomarkers, therapeutic targets, and prognostic indicators.

Results

In cardiology, microRNAs, small noncoding RNA molecules, are crucial to the posttranscriptional regulation of genes. Their role in regulating cardiac cell differentiation and maturation is critical during the development of the heart. They maintain the cardiac function of an adult heart by contributing to its electrical and contractile activity. By binding to messenger RNA molecules, they inhibit protein translation or degrade mRNA. Several cardiovascular diseases are associated with dysregulation of miRNAs, including arrhythmias, hypertension, atherosclerosis, and heart failure. miRNAs can be used as biomarkers to diagnose and predict diseases as well as therapeutic targets. A variety of state-of-the-art technologies have aided researchers in discovering, profiling, and analyzing miRNAs, including microarray analysis, next-generation sequencing, and others.

Conclusion

Developing new diagnostics and therapeutic approaches is becoming more feasible as researchers refine their understanding of miRNA function. Ultimately, this will reduce the burden of cardiovascular disease around the world.

导言:心血管疾病是导致全球发病率和死亡率的重要原因。MicroRNA 通过调节各种细胞和组织中的基因表达,在这些疾病的发生和发展过程中起着至关重要的作用。它们在动脉粥样硬化、心力衰竭、心肌梗死和心律失常等疾病中的作用已被广泛研究:本研究概述了有关 miRNA 在心血管疾病发病机制中作用的现有证据。此外,本研究还探讨了目前用于研究 miRNA 在心血管疾病中作用的最先进技术。最后,我们研究了 miRNA 如何作为疾病生物标志物、治疗靶点和预后指标:在心脏病学中,microRNAs(小型非编码 RNA 分子)对基因的转录后调控至关重要。它们在心脏发育过程中调节心脏细胞分化和成熟的作用至关重要。它们通过促进心脏的电活动和收缩活动来维持成人心脏的功能。通过与信使 RNA 分子结合,它们可抑制蛋白质翻译或降解 mRNA。一些心血管疾病与 miRNAs 的失调有关,包括心律失常、高血压、动脉粥样硬化和心力衰竭。miRNAs 可用作诊断和预测疾病的生物标志物以及治疗靶标。各种最先进的技术帮助研究人员发现、剖析和分析 miRNA,包括微阵列分析、新一代测序等:结论:随着研究人员对 miRNA 功能的进一步了解,开发新的诊断和治疗方法正变得越来越可行。最终,这将减轻全世界心血管疾病的负担。
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引用次数: 0
Tracking Telehealth Needs for Individuals With Sickle Cell Disease Through the COVID-19 Pandemic: A Cross-Sectional Survey Study 通过 COVID-19 大流行追踪镰状细胞病患者的远程保健需求:横断面调查研究。
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1002/hsr2.70163
Marsha Treadwell, Lisa Du, Yemi Lawrence, Maxine Gaspar, Kathryn Hassell, Sanjay Shah, Moses Akpan, Nicole Crook, Marcia Taylor, Srila Gopal, For the Pacific Sickle Cell Regional Collaborative

Background and Aim

Pervasive disparities characterize sickle cell disease (SCD) care, including limited access to SCD specialists. Rapid deployment of remote healthcare provision and support during the COVID-19 pandemic provides an opportunity to understand telehealth barriers/facilitators for SCD. We aimed to evaluate telehealth experiences and satisfaction for routine visits among adults and caregivers of children with SCD within a US regional collaborative.

Methods

151 adults ≥ 18 [median (IQR) = 36 (28, 43) years], and 94 caregivers [median child age (IQR) = 12 (7, 14) years] completed a 30-item online survey in 2021 assessing systems issues such as reliable Internet; health information sharing; and consumer focus (e.g., visit started on time). A multivariable logistic regression model was used to evaluate relations between independent variables and the outcome overall satisfaction with telehealth.

Results

Patients were primarily diagnosed with sickle cell anemia (60.8%) and prescribed hydroxyurea (57.6%). Satisfaction with telehealth was high (> 90%), but 60.6% of caregivers gave the highest rating compared with 44.9% of adults (p = 0.02). Few accessibility/technical issues were cited, however, caregivers reported more often having home support for telehealth (80.9% vs. 63.6%, p = 0.003). In multivariable analyses, participants seen in large centers (> 200) were more likely to give the highest satisfaction ratings compared with those in smaller centers (< 100, aOR: 2.33; 95% CI: 1.21, 4.48, p = 0.01); however, those who needed help from a telehealth navigator were less likely to give the highest telehealth experience rating versus those who did not need help (aOR: 0.37; 95% CI: 0.19, 0.71, p = 0.003).

Conclusion

Views of telehealth were favorable, although caregivers reported greater satisfaction and resources compared with adults with SCD. It remains important to identify factors related to telehealth utilization and efficacy for SCD populations in varied geographies and settings, to ensure equity in access.

背景和目的:镰状细胞病 (SCD) 护理中普遍存在不平等现象,包括获得 SCD 专家治疗的机会有限。在 COVID-19 大流行期间,远程医疗服务和支持的快速部署为了解 SCD 的远程医疗障碍/促进因素提供了机会。方法:151 名年龄≥ 18 岁的成年人[中位数(IQR)= 36 (28, 43)岁]和 94 名照顾者[中位数儿童年龄(IQR)= 12 (7, 14)岁]在 2021 年完成了一项包含 30 个项目的在线调查,评估系统问题,如可靠的互联网、健康信息共享和消费者关注点(如按时就诊)。采用多变量逻辑回归模型评估自变量与远程医疗总体满意度结果之间的关系:患者主要被诊断为镰状细胞性贫血(60.8%),处方为羟基脲(57.6%)。对远程医疗的满意度很高(> 90%),但 60.6% 的护理人员给予了最高评价,而成人仅为 44.9%(p = 0.02)。很少有人提到远程医疗的可及性/技术问题,但护理人员表示远程医疗更经常得到家庭支持(80.9% 对 63.6%,p = 0.003)。在多变量分析中,在大型中心(大于 200 人)就诊的参与者与在小型中心就诊的参与者相比,更有可能给出最高满意度评分(p = 0.01);然而,与不需要帮助的参与者相比,需要远程医疗导航员帮助的参与者给出最高远程医疗体验评分的可能性较低(aOR:0.37;95% CI:0.19,0.71,p = 0.003):尽管与 SCD 成人相比,护理人员报告了更高的满意度和更多的资源,但他们对远程医疗的看法是积极的。确定不同地区和环境中 SCD 患者使用远程医疗的相关因素和疗效,以确保使用的公平性,仍然非常重要。
{"title":"Tracking Telehealth Needs for Individuals With Sickle Cell Disease Through the COVID-19 Pandemic: A Cross-Sectional Survey Study","authors":"Marsha Treadwell,&nbsp;Lisa Du,&nbsp;Yemi Lawrence,&nbsp;Maxine Gaspar,&nbsp;Kathryn Hassell,&nbsp;Sanjay Shah,&nbsp;Moses Akpan,&nbsp;Nicole Crook,&nbsp;Marcia Taylor,&nbsp;Srila Gopal,&nbsp;For the Pacific Sickle Cell Regional Collaborative","doi":"10.1002/hsr2.70163","DOIUrl":"10.1002/hsr2.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Pervasive disparities characterize sickle cell disease (SCD) care, including limited access to SCD specialists. Rapid deployment of remote healthcare provision and support during the COVID-19 pandemic provides an opportunity to understand telehealth barriers/facilitators for SCD. We aimed to evaluate telehealth experiences and satisfaction for routine visits among adults and caregivers of children with SCD within a US regional collaborative.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>151 adults ≥ 18 [median (IQR) = 36 (28, 43) years], and 94 caregivers [median child age (IQR) = 12 (7, 14) years] completed a 30-item online survey in 2021 assessing systems issues such as reliable Internet; health information sharing; and consumer focus (e.g., visit started on time). A multivariable logistic regression model was used to evaluate relations between independent variables and the outcome overall satisfaction with telehealth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients were primarily diagnosed with sickle cell anemia (60.8%) and prescribed hydroxyurea (57.6%). Satisfaction with telehealth was high (&gt; 90%), but 60.6% of caregivers gave the highest rating compared with 44.9% of adults (<i>p</i> = 0.02). Few accessibility/technical issues were cited, however, caregivers reported more often having home support for telehealth (80.9% vs. 63.6%, <i>p</i> = 0.003). In multivariable analyses, participants seen in large centers (&gt; 200) were more likely to give the highest satisfaction ratings compared with those in smaller centers (&lt; 100, aOR: 2.33; 95% CI: 1.21, 4.48, <i>p</i> = 0.01); however, those who needed help from a telehealth navigator were less likely to give the highest telehealth experience rating versus those who did not need help (aOR: 0.37; 95% CI: 0.19, 0.71, <i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Views of telehealth were favorable, although caregivers reported greater satisfaction and resources compared with adults with SCD. It remains important to identify factors related to telehealth utilization and efficacy for SCD populations in varied geographies and settings, to ensure equity in access.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"7 11","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current Updates on Variants of SARS-CoV- 2: Systematic Review SARS-CoV- 2变异体的最新进展:系统综述。
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-04 DOI: 10.1002/hsr2.70166
Mulat Erkihun, Bayu Ayele, Zelalem Asmare, Kirubel Endalamaw

Background

Coronavirus disease 2019 is caused by the severe acute respiratory syndrome coronavirus 2, which has become a pandemic. Severe acute respiratory syndrome coronavirus 2 is an enveloped, unsegmented, positive-sense, single-stranded RNA virus that belongs to the family Coronaviridae.

Aim

The objective of this review is to conduct a qualitative analysis of the current updates on epidemiology, evolution, and vaccine variants for SARS-CoV-2.

Method

The search strategy was done from the database based on the PRISMA criteria for qualitative analysis of this review. Literature on variants of severe acute respiratory syndrome coronavirus 2, published in English in the last 5 years (2019–2023), were included. From 179 a total of 105 articles were reviewed, searched, and retrieved from the electronic databases PubMed. The search was done using keywords like COVID-19, SARS-CoV-2, variants, mutations, and vaccines, and articles were managed using EndNote X8 software. The scope of view for this review was the course of the pandemic by emerging variants and how man is struggling to overcome this sudden pandemic through vaccines. The narrative skeleton was constructed based on the article's scope of view.

Result

From the parent severe acute respiratory syndrome coronavirus 2, many variants emerged during the course of this pandemic. They are mainly categorized into two variants: variants of interest and variants of concern based on the impact on public health. The World Health Organization leveled five variants: Alpha (strain B.1.1.7), Beta (strain B.1.351), Gamma (strain P.1), Delta (strain B.1.617.2), and Omicron (B.1.1.529).

Conclusions

It is crucial to stay informed about the latest developments in the understanding of SARS-CoV-2 variants, as new variants can emerge and impact the course of the pandemic. Health authorities and researchers continuously have to monitor and study these variants to assess their characteristics, transmissibility, severity, and the effectiveness of vaccines against them. One has to always refer to the latest information from reputable health journals or organizations for the most up-to-date and accurate details on COVID-19 variants.

背景:2019年冠状病毒病是由严重急性呼吸道综合征冠状病毒2引起的,该病毒已成为一种流行病。严重急性呼吸系统综合征冠状病毒 2 是一种有包膜、无节段、正感、单链 RNA 病毒,属于冠状病毒科。目的:本综述旨在对目前有关 SARS-CoV-2 的流行病学、进化和疫苗变种的最新情况进行定性分析:方法:根据本综述定性分析的 PRISMA 标准,从数据库中制定了搜索策略。纳入了过去 5 年(2019-2023 年)内发表的有关严重急性呼吸系统综合征冠状病毒 2 变体的英文文献。从 179 篇文章中,共审阅、搜索并从电子数据库 PubMed 中检索到 105 篇文章。检索时使用了 COVID-19、SARS-CoV-2、变异、突变和疫苗等关键词,并使用 EndNote X8 软件对文章进行管理。本综述的视角范围是新出现的变异体的大流行过程,以及人类如何通过疫苗努力克服这一突如其来的大流行。根据文章的视角范围构建了叙述骨架:从母体严重急性呼吸系统综合征冠状病毒 2 开始,在这次大流行过程中出现了许多变种。根据对公共卫生的影响,它们主要分为两种变种:关注变种和担忧变种。世界卫生组织将其划分为五个变种:Alpha(B.1.1.7 株)、Beta(B.1.351 株)、Gamma(P.1 株)、Delta(B.1.617.2 株)和 Omicron(B.1.1.529 株):了解 SARS-CoV-2 变异株的最新进展至关重要,因为新的变异株可能会出现并影响大流行病的进程。卫生当局和研究人员必须不断监测和研究这些变种,以评估它们的特征、传播性、严重程度以及疫苗对它们的有效性。有关 COVID-19 变体的最新准确信息,必须始终参考著名卫生期刊或组织提供的最新信息。
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引用次数: 0
Efficacy and Safety of Laser Therapy and Phototherapy in Cicatricial and NonCicatricial Alopecia: A Systematic Review Study 激光疗法和光疗对角化性和非角化性脱发的疗效和安全性:系统回顾研究》。
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-04 DOI: 10.1002/hsr2.70180
Mohammad Amin Jafari, Ghazal Bazgir, Fatemeh Sadat Hosseini-Baharanchi, Alireza Jafarzadeh, Azadeh Goodarzi

Background and Aims

In recent years, the application of various light and laser devices in the treatment of different types of alopecia has been established. This systematic review aims to assess the efficacy and safety of laser therapy and phototherapy in cicatricial and non-cicatricial alopecia.

Methods

A comprehensive search was conducted on PubMed, Scopus, Science Direct, and Google Scholar. Articles were evaluated across four subgroups: alopecia areata, androgenic alopecia, telogen effluvium, and cicatricial alopecia. Included studies were published in English or Persian between January 2010 and September 2023, focusing on interventional, cohort, or case series research that achieved a minimum score of 75% on the EBL checklist. Exclusion criteria encompassed animal and in vitro studies, review articles, case reports, duplicated or irrelevant research, as well as studies that did not meet the designated EBL score. Editorial letters and case studies were also excluded.

Results

Initially, 965 records were collected, resulting in the inclusion of 58 studies in the final review: 26 on alopecia areata, 26 on androgenic alopecia, five on cicatricial alopecia, and one on telogen effluvium. Narrow-band ultraviolet B, 308-nm excimer laser, and psoralen ultraviolet A therapy showed varying effectiveness; specifically, the excimer laser was notably effective for patients with shorter disease duration. In androgenic alopecia, erbium-glass and thulium lasers effectively increased hair density but showed a gradual decline posttreatment. Low-level light/laser therapy also increased hair density and diameter and exhibited potential benefits when used alongside minoxidil, but did not significantly enhance outcomes in telogen effluvium treatment.

Conclusion

Light/laser therapy can serve as an additive treatment for cicatricial alopecia, particularly lichen planopilaris, but has limited efficacy in treating telogen effluvium. Overall, light/laser therapies exhibit a significant positive effect on increasing hair density and diameter across various alopecia types.

背景和目的:近年来,各种光疗和激光设备在不同类型脱发治疗中的应用已经确立。本系统综述旨在评估激光疗法和光疗对环状脱发和非环状脱发的疗效和安全性:方法:在 PubMed、Scopus、Science Direct 和 Google Scholar 上进行了全面搜索。对四个亚组的文章进行了评估:斑秃、雄激素性脱发、毛囊性脱发和卡他性脱发。所纳入的研究均在 2010 年 1 月至 2023 年 9 月期间以英语或波斯语发表,侧重于干预性、队列或病例系列研究,并在 EBL 检查表中达到至少 75% 的分数。排除标准包括动物和体外研究、综述文章、病例报告、重复或不相关的研究,以及未达到指定 EBL 分数的研究。编辑信和病例研究也被排除在外:最初共收集到 965 条记录,最终纳入 58 项研究:结果:最初共收集到 965 条记录,最终纳入了 58 项研究:26 项关于斑秃,26 项关于雄激素性脱发,5 项关于卡他性脱发,1 项关于毛囊性脱发。窄波段紫外线 B、308 纳米准分子激光和补骨脂素紫外线 A 的疗效各不相同;具体而言,准分子激光对病程较短的患者疗效显著。对于雄激素性脱发,铒玻璃激光和铥激光能有效增加毛发密度,但治疗后毛发密度会逐渐下降。低强度光/激光疗法也能增加毛发密度和直径,与米诺西地同时使用时也有潜在疗效,但并不能显著提高毛囊性脱发的治疗效果:光疗法/激光疗法可作为环状脱发(尤其是扁平苔藓)的辅助疗法,但对治疗毛囊性脱发的疗效有限。总体而言,光疗法/激光疗法对增加各种脱发类型的毛发密度和直径有显著的积极作用。
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引用次数: 0
Different minimally invasive surgical methods to hysterectomy for benign gynecological disease: A systematic review and network meta-analysis 良性妇科疾病子宫切除术的不同微创手术方法:系统综述和网络荟萃分析。
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-03 DOI: 10.1002/hsr2.70137
Meijun Guan, Hui Li, Tian Tian, Jirong Peng, Yan Huang, Li He

Background and Aims

This network meta-analysis aimed to compare the perioperative efficacy of various minimally invasive hysterectomy procedures for treating benign gynecological diseases and to assess whether vaginal natural orifice transluminal endoscopic hysterectomy (VNOTEH), a recently emerging procedure, is inferior to traditional laparoscopy.

Methods

We searched PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), Wanfang Data, and China VIP Database from inception to August 2022 and updated in June 2023. We included randomized controlled trials (RCTs) comparing different minimally invasive hysterectomy techniques in patients with benign gynecological conditions. The intervention measures included nine minimally invasive hysterectomies. The two researchers used the Cochrane risk-of-bias assessment tool for study appraisal. All statistical analyses and drawings were performed using STATA 17.0 and R 4.4.1. A network meta-analysis (NMA) was conducted to compare the effectiveness of minimally invasive hysterectomy and rank its relative impact probabilistically.

Results

A total of 78 RCTs involving 7640 patients and nine minimally invasive hysterectomy methods with 16 intervention combinations were included in this study. Among these, 2, 63, and 13 studies were deemed to have a low, medium, and high risk of bias, respectively. Based on the Surface Under the Cumulative Ranking (SUCRA) probability ranking results of NMA, laparoendoscopic single-site surgery-laparoscopic-assisted vaginal hysterectomy (LESS-LAVH) demonstrated superior outcomes in terms of complications, infections, and 24-h postoperative pain scores. LAVH exhibited better performance in injuries and hospital stays, total laparoscopic hysterectomy showed the least blood loss, and vaginal hysterectomy had the shortest operation time.

Conclusion

LESS-LAVH and LAVH are recommended options, if feasible. Meanwhile, VNOTEH can achieve comparable results to traditional laparoscopy but requires careful attention to the risk of injury and infection. Future research should aim to broaden the search scope by including high-quality, large-scale, multicenter RCTs.

背景和目的:本网络荟萃分析旨在比较各种微创子宫切除术治疗妇科良性疾病的围手术期疗效,并评估阴道自然腔道内镜下子宫切除术(VNOTEH)这一最近兴起的手术是否不如传统腹腔镜手术:我们检索了PubMed、Cochrane图书馆、Embase、中国国家知识基础设施(CNKI)、中国生物医学文献数据库(CBM)、万方数据和中国VIP数据库(从开始到2022年8月,并于2023年6月更新)。我们纳入的随机对照试验(RCT)比较了针对良性妇科疾病患者的不同微创子宫切除术技术。干预措施包括九种微创子宫切除术。两位研究人员使用 Cochrane 偏倚风险评估工具对研究进行评估。所有统计分析和绘图均使用 STATA 17.0 和 R 4.4.1 进行。进行了网络荟萃分析(NMA),以比较微创子宫切除术的有效性,并对其相对影响进行概率排序:本研究共纳入 78 项 RCT,涉及 7640 名患者,9 种微创子宫切除术方法,16 种干预组合。其中,分别有 2 项、63 项和 13 项研究被认为存在低、中和高偏倚风险。根据NMA的表面累积排名(Surface Under the Cumulative Ranking,SUCRA)概率排名结果,腹腔内镜单部位手术-腹腔镜辅助阴道子宫切除术(LESS-LAVH)在并发症、感染和术后24小时疼痛评分方面表现出更优越的结果。LAVH在损伤和住院时间方面表现更佳,全腹腔镜子宫切除术的失血量最少,阴式子宫切除术的手术时间最短:结论:如果可行,LESS-LAVH 和 LAVH 是推荐的选择。结论:在可行的情况下,LESS-LAVH 和 LAVH 是值得推荐的选择,而 VNOTEH 可以达到与传统腹腔镜手术相当的效果,但需要注意损伤和感染的风险。未来的研究应旨在扩大搜索范围,纳入高质量、大规模、多中心的 RCT。
{"title":"Different minimally invasive surgical methods to hysterectomy for benign gynecological disease: A systematic review and network meta-analysis","authors":"Meijun Guan,&nbsp;Hui Li,&nbsp;Tian Tian,&nbsp;Jirong Peng,&nbsp;Yan Huang,&nbsp;Li He","doi":"10.1002/hsr2.70137","DOIUrl":"10.1002/hsr2.70137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>This network meta-analysis aimed to compare the perioperative efficacy of various minimally invasive hysterectomy procedures for treating benign gynecological diseases and to assess whether vaginal natural orifice transluminal endoscopic hysterectomy (VNOTEH), a recently emerging procedure, is inferior to traditional laparoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), Wanfang Data, and China VIP Database from inception to August 2022 and updated in June 2023. We included randomized controlled trials (RCTs) comparing different minimally invasive hysterectomy techniques in patients with benign gynecological conditions. The intervention measures included nine minimally invasive hysterectomies. The two researchers used the Cochrane risk-of-bias assessment tool for study appraisal. All statistical analyses and drawings were performed using STATA 17.0 and R 4.4.1. A network meta-analysis (NMA) was conducted to compare the effectiveness of minimally invasive hysterectomy and rank its relative impact probabilistically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 78 RCTs involving 7640 patients and nine minimally invasive hysterectomy methods with 16 intervention combinations were included in this study. Among these, 2, 63, and 13 studies were deemed to have a low, medium, and high risk of bias, respectively. Based on the Surface Under the Cumulative Ranking (SUCRA) probability ranking results of NMA, laparoendoscopic single-site surgery-laparoscopic-assisted vaginal hysterectomy (LESS-LAVH) demonstrated superior outcomes in terms of complications, infections, and 24-h postoperative pain scores. LAVH exhibited better performance in injuries and hospital stays, total laparoscopic hysterectomy showed the least blood loss, and vaginal hysterectomy had the shortest operation time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LESS-LAVH and LAVH are recommended options, if feasible. Meanwhile, VNOTEH can achieve comparable results to traditional laparoscopy but requires careful attention to the risk of injury and infection. Future research should aim to broaden the search scope by including high-quality, large-scale, multicenter RCTs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"7 11","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Virulence genes and antibiotic susceptibility patterns of Escherichia coli isolated from nosocomial urinary tract infections in the northwest of Iran during 2022–2023: A cross-sectional study 2022-2023 年期间伊朗西北部从医院内尿路感染中分离的大肠埃希菌的毒力基因和抗生素敏感性模式:一项横断面研究。
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-30 DOI: 10.1002/hsr2.70149
Mohammad Yousef Memar, Masoud Vosughi, Yalda Rahbar Saadat, Mohammadreza Ardalan, Mina Yekani, Bahram Niknafs, Sepideh Zununi Vahed

Background and Aims

Urinary tract infections (UTIs) are prevalent among hospitalized patients, constituting the most frequent health-care infections. Uropathogenic Escherichia coli (UPEC) is leading causative agent of UTIs. The present study was aimed to examine the susceptibility of UPEC isolates obtained from nosocomial cases to antibiotics, as well as their biofilm formation capability and frequency of virulence genes.

Methods

A total of 100 UPEC isolates were collected from nosocomial UTIs at Imam Reza Hospitals in Tabriz, Iran, spanning from April 2022 to January 2023. The antimicrobial susceptibility patterns were evaluated using the disk diffusion method, along with the detection of broad-spectrum β-lactam enzymes (ESBLs) and carbapenemases. The ability of isolates to form biofilms was assessed using the microtiter-plate method, while the PCR method was employed to identify the presence of virulence genes.

Results

The highest resistance was observed toward piperacillin (82%), followed by aztreonam and ciprofloxacin (81%), while the lowest resistance was found against piperacillin/tazobactam (12%) and meropenem (9%). ESBLs were detected in 62% of the isolates. The microtiter-plate results revealed strong, moderate, and weak biofilm formation abilities in 32%, 33%, and 24% of the isolates, respectively. The most prevalent virulence gene was fimA (74%) followed by hlyF (68%), papA (44%), papC (32%), iroN (26%), and cnf (20%).

Conclusion

The elevated levels of resistance to multiple antimicrobial agents, coupled with the co-presence of virulence genes and biofilm formation abilities, contribute to the persistence of UPEC-related infections, particularly in hospitalized patients. These findings underscore the necessity of implementing an effective program to control nosocomial UTIs caused by UPEC in the healthcare centers.

背景和目的:尿路感染(UTI)在住院病人中很普遍,是最常见的医疗感染。尿路致病性大肠杆菌(UPEC)是尿路感染的主要致病菌。本研究旨在检测从医院病例中分离出的 UPEC 对抗生素的敏感性,以及它们形成生物膜的能力和毒力基因的频率:从2022年4月至2023年1月期间,从伊朗大不里士市伊玛目礼萨医院的医院性UTI病例中收集了100株UPEC分离株。采用磁盘扩散法评估了抗菌药敏感性模式,并检测了广谱β-内酰胺酶(ESBLs)和碳青霉烯酶。采用微孔板法评估了分离物形成生物膜的能力,同时采用 PCR 法确定了毒力基因的存在:哌拉西林的耐药性最高(82%),其次是阿曲南和环丙沙星(81%),而哌拉西林/他唑巴坦(12%)和美罗培南(9%)的耐药性最低。在 62% 的分离株中检测到了 ESBLs。微孔板结果显示,分别有 32%、33% 和 24% 的分离株具有较强、中等和较弱的生物膜形成能力。最常见的毒力基因是 fimA(74%),其次是 hlyF(68%)、papA(44%)、papC(32%)、iroN(26%)和 cnf(20%):结论:对多种抗菌药物的耐药性水平升高,加上毒力基因和生物膜形成能力的共同存在,导致与 UPEC 相关的感染持续存在,尤其是在住院患者中。这些发现强调了在医疗中心实施有效计划控制由UPEC引起的院内UTI的必要性。
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引用次数: 0
Prevalence and Correlates of Poor Sleep Quality Among Psychiatry Physicians in Saudi Arabia: A Cross-Sectional Study 沙特阿拉伯精神科医生睡眠质量差的患病率及相关因素:一项横断面研究。
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-30 DOI: 10.1002/hsr2.70170
Najim Z. Alshahrani, Abdullah M. Alarifi, Wejdan Saqer Alotaibi, Afnan Abdulrahman Alsayed, Khalid Sultan Latif Alwasm, Alaa Abdulkarim Alhunti, Lana Alaa AlDahleh, Meaad Mohammed A Alshahrani, Abdalrhman M. Albeshry, Mohammed A. Aljunaid

Background and Aims

Sleep issues pose a significant burden to public health and well-being in Saudi Arabia. However, research evidence on sleep health among psychiatry physicians in this territory is limited. Therefore, to bridge the research gap, this study was designed to assess the prevalence and predictors of poor sleep quality among psychiatry physicians in the country.

Methods

This cross-sectional study included 554 psychiatry physicians in Saudi Arabia from March to August 2023. Data were collected via online through a structured questionnaire (Google survey form). Sleep quality, the outcome variable of our study, was evaluated with the Pittsburgh Sleep Quality Index (PSQI; 19 items). Independent variables included sociodemographic and behavioral characteristics, sleep habits, major depression (assessed with Patient Health Questionnaire-9), and anxiety (measured with Generalized Anxiety Disorder-7) symptoms. Binary logistic regression analysis was performed to identify the correlates of poor sleep quality.

Results

Based on the PSQI, 61.3% of the study participants had poor-quality sleep (age range: 24–56 years, male: 48.0%). The adjusted model revealed that male participants (AOR = 2.80, 95% CI = 1.70–4.61) and those who had on-call duties ≥ 2 times per week (for three/four per week: AOR = 3.41, 95% CI = 1.89–6.14) were at higher risk of developing poor sleep quality compared to their respective counterparts. Participants with depressive symptoms (AOR = 3.46, 95% CI = 1.60–7.48) and smoking habits (AOR = 3.47, 95% CI = 1.32–9.08) had higher odds of developing poor sleep quality than their counterparts. Moreover, participants who always used their smartphone/laptop before going to bed were more likely to have poor sleep quality than those who never used such (AOR = 3.15, 95% CI = 1.31–7.60).

Conclusion

Poor sleep quality is extremely prominent among psychiatry physicians in Saudi Arabia. Male sex, higher on-call duty, smoking habits, depression, and smartphone/laptop use before bedtime were significantly associated with poor sleep quality. These findings emphasize the need for sleep-health promotion interventions for Saudi psychiatry physicians.

背景和目的:睡眠问题给沙特阿拉伯的公众健康和福祉造成了沉重负担。然而,有关该地区精神科医生睡眠健康的研究证据却很有限。因此,为了弥补这一研究空白,本研究旨在评估该国精神科医生睡眠质量差的发生率和预测因素:这项横断面研究包括沙特阿拉伯的 554 名精神科医生,研究时间为 2023 年 3 月至 8 月。数据通过结构化问卷(谷歌调查表)在线收集。睡眠质量是本研究的结果变量,采用匹兹堡睡眠质量指数(PSQI;19 个项目)进行评估。自变量包括社会人口学特征和行为特征、睡眠习惯、重度抑郁(以患者健康问卷-9进行评估)和焦虑(以广泛性焦虑症-7进行测量)症状。为了确定睡眠质量差的相关因素,我们进行了二元逻辑回归分析:根据 PSQI,61.3% 的研究参与者睡眠质量不佳(年龄范围:24-56 岁,男性:48.0%)。调整后的模型显示,男性参与者(AOR = 2.80,95% CI = 1.70-4.61)和每周值班≥2次者(每周值班3/4次:AOR = 3.41,95% CI = 1.89-6.14)的睡眠质量较差风险较高。有抑郁症状(AOR = 3.46,95% CI = 1.60-7.48)和吸烟习惯(AOR = 3.47,95% CI = 1.32-9.08)的参与者出现睡眠质量不佳的几率高于其他参与者。此外,睡前经常使用智能手机/笔记本电脑的参与者比从不使用智能手机/笔记本电脑的参与者更容易出现睡眠质量差的情况(AOR = 3.15,95% CI = 1.31-7.60):在沙特阿拉伯,睡眠质量差在精神科医生中极为突出。男性性别、较高的值班率、吸烟习惯、抑郁和睡前使用智能手机/笔记本电脑与睡眠质量差有显著关联。这些发现强调了对沙特精神科医生进行睡眠健康促进干预的必要性。
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引用次数: 0
News Media Reports of Respiratory Syncytial Virus in Canada and the United States During the 2022–2023 Respiratory Virus Season: A Cross-Sectional Study 2022-2023 年呼吸道病毒流行季节加拿大和美国有关呼吸道合胞病毒的新闻媒体报道:横断面研究
IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-30 DOI: 10.1002/hsr2.70146
Sherilyn K. D. Houle, Silvia Luk
<p>The 2022/2023 respiratory syncytial virus (RSV) season was marked by early and above-average case counts, at least partially attributed to the lifting of public health measures such as masking and physical distancing implemented during the early years of the coronavirus disease 2019 (COVID-19) pandemic [<span>1</span>]. Uniquely, it was also the last season before the availability of vaccines. In May 2023, two recombinant subunit vaccines were approved by the US Food & Drug Administration for use in adults aged 60 years and older (Arexvy and ABRYSVO), with ABRYSVO also indicated for maternal immunization [<span>2, 3</span>].</p><p>While hospitalization rates for RSV-related causes is highest among young children [<span>4, 5</span>], mortality is most marked among older adults [<span>6-8</span>]. Healthcare professionals also have greater awareness of RSV among pediatric patients than among older adults. In Italy, 21.7% of surveyed general practitioners correctly associated the majority of RSV-related deaths with older adults, and only 38.9% of participants understood RSV infection as not limited to infants and children [<span>9</span>]. Among US physicians in primary care, 57% reported rarely considering RSV as a potential pathogen in their patients ≥ 50 years old with respiratory disease [<span>10</span>]. Regarding maternal vaccination, a survey of obstetricians and midwives in England reported that 66% of midwives had no or very little awareness of RSV in contrast to 14% of obstetricians, and that routine maternal vaccination against RSV would be recommended by 79% and 89% of midwives and obstetricians, respectively [<span>11</span>]. Research gaps remain related to knowledge and attitudes of other health professionals involved with recommending and administering vaccines (such as nurses and pharmacists) and the public, with one study reporting that 60% of surveyed adults with diabetes in the US had never heard of RSV [<span>12</span>], and 88% of surveyed pregnant women in South England reported having little or no knowledge of RSV [<span>11</span>].</p><p>Here, we report on the frequency and content of news media publications related to RSV over the 2022/2023 season in Canada and the United States, hypothesizing that coverage focused on the impact of RSV among the pediatric population with the potential to subsequently contribute to complacency around vaccination of older adults and those who are pregnant.</p><p>Over the study period, 928 unique publications were identified across 29 outlets (Table 1). Of these, 899 (96.9%) discussed RSV among the pediatric population, 310 (33.4%) among older adults, and 104 (11.2%) mentioned maternal immunization. HuffPost was excluded as an eligible outlet as a search function was not available online, and no publications were identified from CNN over the study period. Over this same period, 194,095 positive tests for RSV were reported in the United States and 39,484 in Canada; however, RSV case dat
2022/2023 年呼吸道合胞病毒(RSV)流行季的特点是病例数较早且高于平均水平,这至少部分归因于 2019 年冠状病毒病(COVID-19)大流行初期实施的掩蔽和物理隔离等公共卫生措施的取消[1]。与众不同的是,这也是疫苗上市前的最后一个季节。2023 年 5 月,美国食品和药物管理局批准了两种重组亚单位疫苗用于 60 岁及以上的成年人(Arexvy 和 ABRYSVO),其中 ABRYSVO 还适用于孕产妇免疫接种[2, 3]。医护人员对儿童患者 RSV 的认识也高于老年人。在意大利,21.7% 接受调查的全科医生正确地将大多数 RSV 相关死亡与老年人联系起来,只有 38.9% 的参与者认为 RSV 感染不仅限于婴儿和儿童 [9]。在美国的初级保健医生中,57%的人表示很少将 RSV 视为年龄≥ 50 岁的呼吸道疾病患者的潜在病原体[10]。关于孕产妇疫苗接种,英国一项针对产科医生和助产士的调查报告显示,66% 的助产士不了解或很少了解 RSV,而产科医生的这一比例为 14%,分别有 79% 和 89% 的助产士和产科医生建议孕产妇常规接种 RSV 疫苗[11]。一项研究报告称,美国 60% 的受访成人糖尿病患者从未听说过 RSV[12],南英格兰 88% 的受访孕妇表示对 RSV 知之甚少或一无所知[11]。在此,我们报告了 2022/2023 年加拿大和美国季节期间与 RSV 相关的新闻媒体出版物的频率和内容,并推测报道的重点是 RSV 在儿科人群中的影响,这有可能导致老年人和孕妇对疫苗接种的自满情绪。在研究期间,29 家媒体共发表了 928 篇独特的出版物(表 1)。其中,899 篇(96.9%)讨论了儿科人群中的 RSV,310 篇(33.4%)讨论了老年人中的 RSV,104 篇(11.2%)提到了孕产妇免疫接种。由于 HuffPost 不具备在线搜索功能,因此被排除在符合条件的媒体之外,在研究期间也没有发现 CNN 的出版物。在同一时期,美国报告了 194,095 例 RSV 阳性检测,加拿大报告了 39,484 例;但是,加拿大没有报告截至 2022 年 12 月 24 日的第 51 周的 RSV 病例数据。每周的出版物和 RSV 病例检测结果以图表(图 1)和数字的形式显示(辅助信息:表 S1)。值得注意的是,美国食品和药物管理局(FDA)审查委员会分别于2022年5月3日(第18周)和2022年5月31日(第20周)建议批准Arexvy和ABRYSVO[17, 18]。发表文章的数量与报告病例的数量密切相关,讨论老年人和孕产妇中 RSV 的文章在季节早期并不常见,而在季节后期和 FDA 委员会建议批准 Arexvy 作为美国第一种 RSV 疫苗的时间前后则更为流行。2022-2023 年呼吸道病毒流行季的特点是开始较早,病例数高于平均水平,美国和加拿大有关 RSV 的新闻媒体出版物在频率上与 RSV 病例数密切相关,绝大多数出版物讨论的是儿科人群中的 RSV,只有三分之一的出版物讨论了老年人群,尽管后者因 RSV 导致的死亡率较高。2022 年 5 月,提及老年人群和孕产妇免疫接种潜力的文章激增,这与美国食品及药物管理局建议批准针对这些人群的疫苗是一致的;但是,这些激增的文章仅是本季早些时候讨论儿科人群的每周文章的三分之一。造成这种不成比例的报道的原因可能很复杂,而确定这些原因超出了本研究的范围。老龄歧视通常是隐性的和下意识的,可能有多种形式,包括排除在筛查或其他预防工作之外,或治疗虚无主义[19],即对老年人的干预效果信心不足。这种年龄歧视可能导致社会倾向于重点保护年轻人免受 RSV 感染。
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