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Clinical value of CVP+VIVC in predicting fluid resuscitation in patients with septic shock CVP+VIVC预测脓毒性休克患者液体复苏的临床价值
4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-10-11 DOI: 10.4314/ahs.v23i3.52
Haitao Zhang, Chang Liu, Aiping Cao, Qiong Hang
Objective: To explore the clinical value of central venous pressure (CVP) + inferior vena cava respiratory variability (VIVC) in fluid resuscitation in spontaneously breathing patients with septic shock. Methods: In retrospective observational study, during October 2019 to December 2021, 145 patients with septic shock treated in our hospital were enrolled by the method of observational study. According to the change rate of cardiac output (△ CO) ≥15% or △ CO<15% after 30 minutes, they were assigned into volume-responsive and volume-unresponsive group depending early fluid resuscitation in sepsis. The clinical value of combination of CVP and VIVC in predicting fluid resuscitation in patients with septic shock was compared. Results: The CVP of the study group was higher at 12h and 24h after fluid resuscitation, and the VIVC level of the study group at 6h, 12h and 24h after fluid resuscitation was higher (P<0.05). Pearson correlation analysis indicated that CVP, and VIVC levels were noticeably correlated with fluid resuscitation in patients with septic shock (P<0.05). The area under curve (AUC) of receiver operating characteristic curve (ROC) of CVP for predicting fluid resuscitation in septic shock patients was 0.694 and the cut-off value was 0.932, the sensitivity was 46.9%, and the specificity was 87.5%. VIVC predicted fluid resuscitation in septic shock patients with an AUC of 0.776, which was a cut-off value of 0.688, a sensitivity of 50.0%, and a specificity of 90.0%. Combination of CVP and VIVC predicted fluid resuscitation in septic shock patients with an AUC of 0.948, which was a cut-off value of 1.420, a sensitivity of 90.6%, and a specificity of 87.5%. Conclusion: Combination of CVP and VIVC may have a good effect on the evaluation of volume responsiveness in patients with septic shock, which is better than single CVP and VIVC. Combination of CVP and VIVC can be adopted to predict fluid responsiveness volume responsiveness in septic shock patients, which is of great significance for guiding clinical fluid responsiveness therapy. Keywords: Septic shock; fluid resuscitation; CVP; VIVC.
目的:探讨中心静脉压(CVP) +下腔静脉呼吸变异性(VIVC)在脓毒性休克自主呼吸患者液体复苏中的临床价值。方法:采用回顾性观察研究方法,选取2019年10月至2021年12月在我院接受治疗的感染性休克患者145例。根据30min后心输出量(△CO)变化率≥15%或△CO<15%,根据脓毒症早期液体复苏分为容量反应组和容量无反应组。比较CVP与VIVC联合预测脓毒性休克患者液体复苏的临床价值。 结果:研究组在液体复苏后12h、24h CVP较高,研究组在液体复苏后6h、12h、24h VIVC水平较高(p < 0.05)。Pearson相关分析显示,CVP、VIVC水平与脓毒性休克患者液体复苏显著相关(P<0.05)。CVP预测脓毒性休克患者液体复苏的受试者工作特征曲线(ROC)曲线下面积(AUC)为0.694,临界值为0.932,敏感性为46.9%,特异性为87.5%。VIVC预测脓毒性休克患者液体复苏的AUC为0.776,截断值为0.688,敏感性为50.0%,特异性为90.0%。CVP与VIVC联合预测脓毒性休克患者液体复苏的AUC为0.948,截断值为1.420,敏感性为90.6%,特异性为87.5%。 结论:CVP联合VIVC对脓毒性休克患者的容量反应性评价有较好的效果,优于单独CVP和VIVC。CVP和VIVC联合应用可预测脓毒性休克患者的液体反应性和体积反应性,对指导临床液体反应性治疗具有重要意义。 关键词:感染性休克;液体复苏;本量利;VIVC。
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引用次数: 0
Molecular characterization of multidrug resistant (MDR) clinical isolates of Pseudomonas aeruginosa from Nsukka, South Eastern Nigeria 尼日利亚东南部Nsukka多药耐药铜绿假单胞菌临床分离株的分子特征
4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-10-11 DOI: 10.4314/ahs.v23i3.57
Martina C Agbo, Kenneth O Ugwu, Boniface N Ukwah, Ifeoma M Ezeonu
Background: P. aeruginosa is an important nosocomial pathogen with increasing resistance to antibiotics. Objective: This studywas performed to evaluate the genetic relatedness of MDR clinical isolates of P. aeruginosa. Method: A total of 1000 samples were analysed in the study. Antibiotic resistance profiles of the isolates were determined usingKirby Bauer disk diffusion method. Polymerase chain reaction (PCR) and sequencing were simultaneously used to detect theconsensus region of 16S rRNA. Genetic relatedness of the isolates was determined using restriction patterns from ALU 1 digestand random amplified polymorphic DNA. Results: Out of the 192 P. aeruginosa isolates recovered, 136 (78.83%) were multidrug resistant. Sequence analysis of the confirmedisolates (80.68%) revealed that all the isolates shared homology with each other and also showed sequence similarity toknown strains of P. aeruginosa (ATCC 27853; KT 315654; KU 321274 and KT894767). The PCR-Restriction fragment lengthpolymorphism (PCR-RFLP) analysis revealed that there was a lot of genetic relatedness among the isolates. The RFLP fingerprinting technique detected seven distinct RFLP types among the isolates. Conclusions: Thus, study shows that there is high prevalence of MDRPA and high degree of genetic relatedness among theMDRPA isolates circulating in Nsukka area. Keywords: MDRPA; PCR-RFLP; RAPD; Sequencing; 16S rRNA gene.
背景:铜绿假单胞菌(P. aeruginosa)是一种重要的院内病原菌,对抗生素的耐药性日益增强。目的:评价耐多药铜绿假单胞菌临床分离株的遗传相关性。方法:对1000份样本进行分析。采用kirby Bauer纸片扩散法测定菌株的耐药谱。采用聚合酶链反应(PCR)和测序同时检测16S rRNA的一致区。利用ALU 1消化酶和随机扩增多态性DNA的限制性内切模式来确定分离物的遗传亲缘关系。结果:回收的192株铜绿假单胞菌中,有136株(78.83%)耐多药。序列分析表明,所有分离株均具有同源性,且序列与已知铜绿假单胞菌(P. aeruginosa, ATCC 27853;KT 315654;kt321274和KT894767)。聚合酶链反应-限制性内切片段长度多态性(PCR-RFLP)分析表明,分离株间存在较强的遗传亲缘关系。RFLP指纹图谱技术检测出7种不同的RFLP类型。 结论:研究表明,Nsukka地区流行的MDRPA分离株具有较高的流行率和高度的遗传亲缘性。关键词:MDRPA;PCR-RFLP;RAPD;测序;16S rRNA基因。
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引用次数: 0
Digestive manifestations of Covid-19 in children: a retrospective study 儿童Covid-19消化道表现:一项回顾性研究
4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-10-11 DOI: 10.4314/ahs.v23i3.22
Abderrahmane Jallouli, Karima El Fakiri, Houda Nassih, Rabiy EL Qadiry, Aicha Bourrahouat, Imane Ait Sab, Noureddine Rada, Ghizlane Draiss, Mohammed Bouskraoui
Background: The world is currently facing a pandemic due to a new species of the Coronaviridae family called SARS-CoV-2,discovered in the city of Wuhan in China in December 2019. The WHO has named the resulting disease COVID-19 (CoronavirusDisease 2019). It has been a global health problem due to its major socio-economic damage. The aim of this study was toshow the prevalence of gastrointestinal and hepatic manifestations in symptomatic children with COVID-19. Methods: We performed a retrospective study, including 36 symptomatic children infected by SARS-CoV-2 hospitalized at themother and child hospital of university hospital of Mohammed VI, Marrakech in Morocco, over a period of 7 months. Clinicaland biological manifestations of the digestive system were evaluated for all patients. Results: The digestive symptomatology came in second place after the respiratory manifestations. 14 patients (38.89 % ofsymptomatic patients) in our study had digestive symptoms on admission: 12 (33.33%) presented with diarrhea, 4 (11.11%) hadabdominal pain and only one child (2.78%) had vomiting. Aspartate aminotransferase (AST) was elevated in one patient, whilealanine transaminase (ALT) was elevated in 6 patients. The prothrombin level was normal in all patients. All patients were dischargedwith good general condition without morbidity and mortality. Conclusion: This study concludes with the high prevalence of digestive manifestations of COVID-19 in symptomatic children.There were no severe clinical or biological abnormalities in our study. Digestive manifestations during COVID-19 in childrenare frequent, which requires the awareness of health professionals Keywords: COVID-19; digestive manifestations; children.
背景:由于2019年12月在中国武汉市发现了一种名为SARS-CoV-2的冠状病毒科新物种,世界目前正面临一场大流行。世卫组织将由此产生的疾病命名为COVID-19(2019冠状病毒病)。由于其严重的社会经济损害,它已成为一个全球性的健康问题。本研究的目的是显示有症状的COVID-19儿童胃肠道和肝脏表现的患病率。方法:对在摩洛哥马拉喀什穆罕默德六世大学医院母婴医院住院的36例有症状的SARS-CoV-2感染儿童进行回顾性研究,研究时间为7个月。评估所有患者消化系统的临床和生物学表现。 结果:消化症状排在呼吸症状之后。本组14例患者(占有症状患者的38.89%)入院时出现消化系统症状,其中腹泻12例(33.33%),腹痛4例(11.11%),呕吐1例(2.78%)。1例患者谷草转氨酶(AST)升高,6例患者谷丙转氨酶(ALT)升高。所有患者凝血酶原水平均正常。所有患者出院时一般情况良好,无发病率和死亡率。结论:COVID-19在有症状的儿童中消化道表现高发。在我们的研究中没有严重的临床或生物学异常。儿童COVID-19期间的消化系统表现很常见,这需要卫生专业人员的认识 关键词:COVID-19;消化道症状;的孩子。
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引用次数: 0
Values of serum neutrophil gelatinase-associated lipocalin and cystatin C after percutaneous coronary intervention for early diagnosis of contrast-induced nephropathy 经皮冠状动脉介入治疗后血清中性粒细胞明胶酶相关脂钙素和胱抑素C对造影剂肾病早期诊断的价值
4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-10-11 DOI: 10.4314/ahs.v23i3.69
Ping Luo, Wei Ao, Dikai Xiang, Jian Wang, Jia Liu
Objective: Serum creatinine (SCr) is not a sensitive and reliable index for the early diagnosis of acute kidney injury caused bycontrast-induced nephropathy (CIN). The aim of this study was to explore the values of serum neutrophil gelatinase-associatedlipocalin (NGAL) and cystatin C (Cys-C) after percutaneous coronary intervention (PCI) for the early diagnosis of CIN. Methods: Three hundred patients receiving PCI from January 2018 to December 2020 were assigned to a CIN group (n=25)and a non-CIN group (n=275), respectively. SCr, Cys-C and NGAL levels were measured, and their sensitivities for early CINdiagnosis were evaluated by the area under the receiver operating characteristic curve (AUC) values. Results: The NGAL and Cys-C levels of the CIN group began to rise 6 and 12 h after operation, respectively (P<0.05). TheCIN group had higher NGAL and Cys-C levels than those of the non-CIN group 12, 24 and 48 h after operation (P<0.05). TheAUC values of NGAL, Cys-C and SCr 24 h after operation were 0.885, 0.874 and 0.856, respectively. Conclusion: The serum NGAL and Cys-C levels of patients after PCI reflect the early changes of renal function, which arevaluable for early CIN diagnosis. Keywords: Contrast; cystatin C; nephropathy; neutrophil gelatinase-associated lipocalin; percutaneous coronary intervention.
目的:血清肌酐(SCr)是早期诊断造影剂肾病(CIN)急性肾损伤的一个不敏感、不可靠的指标。本研究的目的是探讨经皮冠状动脉介入治疗(PCI)后血清中性粒细胞明胶酶相关脂钙素(NGAL)和胱抑素C (cysc)在早期诊断CIN中的价值。方法:2018年1月至2020年12月接受PCI治疗的患者300例,分别分为CIN组(n=25)和非CIN组(n=275)。测定SCr、Cys-C和NGAL水平,并通过受试者工作特征曲线下面积(AUC)值评价其对早期cind诊断的敏感性。结果:CIN组NGAL和Cys-C水平分别在术后6 h和12 h开始升高(p < 0.05)。术后12、24、48 h, cin组NGAL、Cys-C水平高于非cin组(p < 0.05)。术后24 h NGAL、Cys-C、SCr的auc值分别为0.885、0.874、0.856。 结论:PCI术后患者血清NGAL、Cys-C水平反映早期肾功能变化,对CIN早期诊断有价值。关键词:对比;半胱氨酸蛋白酶抑制物C;肾病;中性粒细胞明胶酶相关脂钙蛋白;经皮冠状动脉介入治疗。
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引用次数: 0
Problem gambling among secondary school adolescents in Enugu, Nigeria 尼日利亚埃努古中学青少年的赌博问题
4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-10-11 DOI: 10.4314/ahs.v23i3.86
Awoere T Chinawa, Edmund N Ossai, Paul C Odinka, Obinna C Nduaguba, Jaclyn I Odinka, Ann E Aronu, Josephat M Chinawa
Background: Adolescent problem gambling is a common behavioural issue and could be associated with internet addiction. Objectives: To determine the pattern of problem gambling and factors that predict gambling among adolescents that attendedsecondary schools in southeast Nigeria. Methodology: This is a cross-sectional study design. A three-stage sampling technique was used to select 796 secondary schooladolescents from eight secondary schools in Enugu State, Nigeria. Results: The highest proportion of the respondents, 38.3% had problem gambling with negative consequences. There was aweak positive correlation between gambling severity index and internet addiction. (n=796, r=0.254, p<0.001). There is a veryweak negative correlation between gambling severity index and age in years. (n=796, r= -0.034, p=0.331).The male respondents were 1.5 times more likely to have problem gambling when compared with the females, (AOR=1.5;(95%CI: 1.1-2.0). The respondents who have internet addiction were 3.5 times more likely to have problem gambling whencompared with those who do not have an internet addiction, (AOR=3.5; 95%CI: 2.6-4.8). Conclusion: The prevalence of gambling among adolescents is high. Adolescents who had problem gambling also had internetaddiction. The male respondents were more likely to have problem gambling than their female folk. Keywords: Problem gambling; secondary school; adolescents; internet addiction; gambling severity index.
背景:青少年问题赌博是一种常见的行为问题,可能与网络成瘾有关。 目的:确定问题赌博模式和预测尼日利亚东南部中学青少年赌博的因素。 方法学:这是一个横断面研究设计。采用三阶段抽样技术,从尼日利亚埃努古州的八所中学中抽取796名中学生。 结果:受访者中有不良赌博行为的比例最高,为38.3%。赌博严重程度指数与网络成瘾呈弱正相关。(n=796, r=0.254, p<0.001)。赌博严重程度指数与年龄呈极弱负相关。(n=796, r= -0.034, p=0.331)。男性受访者有赌博问题的可能性是女性的1.5倍(AOR=1.5; 95%CI: 1.1-2.0)。有网瘾的受访者有赌博问题的可能性是没有网瘾的受访者的3.5倍(AOR=3.5;95%置信区间:2.6—-4.8)# x0D公司;结论:青少年赌博患病率较高。有赌博问题的青少年也有网瘾。男性受访者比女性受访者更有可能出现赌博问题。 关键词:问题赌博;中学;青少年;网络成瘾;赌博严重程度指数。
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引用次数: 0
Epidemiological features of tuberculosis in the Middle East and North Africa from 1990 to 2019: results from the global burden of disease Study 2019 1990年至2019年中东和北非结核病的流行病学特征:2019年全球疾病负担研究结果
4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-10-11 DOI: 10.4314/ahs.v23i3.43
Mehdi Moradinazar, Zienab Mohseni Afshar, Uosef Ramazani, Mohammad Shakiba, Maria Shirvani, Sara Darvishi
Introduction: Tuberculosis (TB) is a preventable and curable disease, although, it still causes more than one million deaths annually. Therefore, the aim of this study was to measure the epidemiological status and the burden of TB in the Middle East and North Africa (MENA) countries. Methods: The study population included 21 countries in the MENA region, covering a population of about 400 million. The Global Burden of Disease (GBD) 2019 database was used. The case definition comprises all forms of TB, containing pulmonary and extra pulmonary TB, which are bacteriologically approved or clinically diagnosed. The prevalence, incidence, death, and the disability-adjusted life years (DALYs) rates per 100,000 people for all national locations by standardized age rates (ASR) were measured. Results: In 2019, Afghanistan had the highest TB-related incidence 85.09 (95% UI, 73.69_98.46), death 21.91 (95% UI, 13.44_29.78), and DALYs rate 695.21 (95% UI, 454.34_939.49). The highest prevalence rates of TB were in Egypt 28935.42 (95% UI, 26125.54_32251.01). The highest TB-related DALYs rate was attributed to alcohol use, high fasting plasma glucose, and smoking were related to Tunisia, Qatar, and Lebanon, respectively. Between 1990 and 2019, TB- related incidence, prevalence, death, and DALYs rate have decreased by 53%, 42.19%, 76.20%, and 75.95% in MENA region, respectively. Conclusion: TB has continued to decrease in prevalence, incidence, death, and DALYs rates in the MENA region, although, nowadays with the COVID-19 pandemic, societies may face more challenges for TB prevention, detection, treatment, and rehabilitation. Keywords: Tuberculosis; disability; burden of disease; DALY; MENA.
简介:结核病是一种可预防和可治愈的疾病,尽管它每年仍造成100多万人死亡。因此,本研究的目的是测量中东和北非(MENA)国家的结核病流行病学状况和负担。方法:研究人群包括中东和北非地区的21个国家,覆盖人口约4亿。使用了2019年全球疾病负担(GBD)数据库。病例定义包括所有形式的结核病,包括细菌学上批准或临床诊断的肺结核和肺外结核。通过标准化年龄率(ASR)测量所有国家地区每10万人的患病率、发病率、死亡率和残疾调整生命年(DALYs)率。 结果:2019年阿富汗结核病相关发病率最高,为85.09 (95% UI, 73.69_98.46),死亡率最高,为21.91 (95% UI, 13.44_29.78), DALYs率最高,为695.21 (95% UI, 454.34_939.49)。埃及肺结核患病率最高,为28935.42 (95% UI, 26125.54_32251.01)。与结核病相关的DALYs率最高的分别是饮酒、空腹血糖高和吸烟,这些国家分别与突尼斯、卡塔尔和黎巴嫩有关。1990年至2019年,中东和北非地区结核病相关发病率、患病率、死亡率和DALYs率分别下降了53%、42.19%、76.20%和75.95%。结论:结核病在中东和北非地区的患病率、发病率、死亡率和DALYs率持续下降,尽管随着COVID-19大流行,社会在结核病预防、检测、治疗和康复方面可能面临更多挑战。关键词:结核病;残疾;疾病负担;戴利;中东和北非地区。
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引用次数: 0
Prevalence and factors associated with neonatal acute respiratory distress syndrome among neonates admitted to the neonatal intensive care units of Gurage zone public hospital, South West Ethiopia 埃塞俄比亚西南部古拉格区公立医院新生儿重症监护病房新生儿急性呼吸窘迫综合征患病率及相关因素
4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-10-11 DOI: 10.4314/ahs.v23i3.20
Bogale Chekole, Terefe Tamene Fetene, Tenaw Shegaw Geze, Zewudie Bitew Tefera, Gebre Eyesus Fisha Alebel, Amare Kassaw, Walle Belete Gelaw, Zeleke Fentahun Tamene, Yemsirach Mira, Tesfu Mulatu, Derartu Deressa
Background: Respiratory distress syndrome (RDS) is the leading cause of respiratory failure and death of a neonate in today's world, especially in developing countries like Ethiopia. Methods: We used an institutional-based cross-sectional study in the selected hospitals of the Gurage zone admitted from June 2019 to June 2021. The data were collected using a structured questionnaire. Data were entered into Epi data 3.1 and exported to SPSS version 25 for analysis. Result: The prevalence of respiratory distress syndrome (RDS) in the study area was 45.1%. The odds of RDS in neonates from mothers with gestational age between 35 &37 were 3.99 times higher compared to term gestation. The odds of RDS among neonates with jaundice and sepsis are 4.33- and 1.92-times higher odds compared to their counterparts. The odds of RDS in neonates born via Caesarean section were 1.7 times higher compared with those delivered via spontaneous and instrumental delivery. RDS was also higher in neonates born to mothers <20 years of age and >=35 years old. Conclusion: the prevalence of RDS in the study area was high. Thus, healthcare providers should act on those factors with appropriate follow-up for early detection of the problem and prevent the risk. Keywords: Respiratory distress syndrome; neonate.
背景:呼吸窘迫综合征(RDS)是当今世界新生儿呼吸衰竭和死亡的主要原因,特别是在埃塞俄比亚等发展中国家。方法:我们对2019年6月至2021年6月入住的古拉格地区选定医院进行了基于机构的横断面研究。数据是通过结构化问卷收集的。数据输入Epi Data 3.1,导出到SPSS 25版进行分析。 结果:研究区呼吸窘迫综合征(RDS)患病率为45.1%。孕龄在35 ~ 37岁的母亲所生的新生儿患RDS的几率是足月的3.99倍。患有黄疸和败血症的新生儿发生RDS的几率分别是其他新生儿的4.33倍和1.92倍。剖腹产出生的新生儿发生RDS的几率是自然分娩和器械分娩的1.7倍。20岁和35岁母亲所生的新生儿RDS也更高。结论:研究区RDS患病率较高。因此,医疗保健提供者应针对这些因素采取行动,并进行适当的随访,以便及早发现问题并预防风险。 关键词:呼吸窘迫综合征;新生儿。
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引用次数: 0
Influence of feedforward control-based health education intervention on compliance, visual function and self-perceived burden among patients with diabetic retinopathy 前馈控制健康教育干预对糖尿病视网膜病变患者依从性、视功能及自我感觉负担的影响
4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-10-11 DOI: 10.4314/ahs.v23i3.39
Jia Wang, Huanyu Tang
Objective: To assess the influence of feedforward control-based health education intervention on the compliance, visual functionand self-perceived burden (SPB) among patients with diabetic retinopathy (DR). Methods: Eighty-six DR patients were divided into feedforward control and control groups (n=43). The control group wasgiven routine nursing intervention, based on which the feedforward control group received feedforward control-based healtheducation intervention. The health behavior indices were compared after intervention. The correlations of QOL score with SPBscore and health behavior indices were analysed using Pearson’s and Spearman’s coefficients. Results: After intervention, the total QOL score and scores of symptoms and visual function, physical function, social activity,and mentality and psychology were significantly improved compared with those before intervention, which were significantlyhigher in the feedforward control group (P<0.05). SPB score was significantly lower in the two groups after intervention thanthat before intervention, particularly in the feedforward control group (P<0.05). The QOL score of DR patients was significantlynegatively correlated with SPB score but positively correlated with health behavior indices (P<0.05). Conclusion: The feedforward control-based health education intervention mode is beneficial for guiding DR patients to promotevisual function recovery and to reduce SPB. Keywords: Correlation; diabetic retinopathy; feedforward control; health education; self-perceived burden; visual function.
目的:探讨前馈控制健康教育干预对糖尿病视网膜病变(DR)患者依从性、视功能和自我感觉负担(SPB)的影响。方法:86例DR患者分为前馈对照组和对照组(n=43)。对照组给予常规护理干预,前馈对照组在此基础上给予基于前馈控制的健康教育干预。比较干预后健康行为指标。采用Pearson 's和Spearman 's系数分析生活质量评分与SPBscore和健康行为指标的相关性。 结果:干预后患者生活质量总分及症状与视觉功能、身体功能、社交活动、心理心理评分均较干预前显著改善,且前馈对照组显著高于干预前(P<0.05)。干预后两组患者SPB评分均显著低于干预前,前馈对照组尤显著(P<0.05)。DR患者的生活质量评分与SPB评分呈显著负相关,与健康行为指标呈显著正相关(p < 0.05)。结论:前馈控制健康教育干预模式有利于指导DR患者促进视功能恢复,降低SPB;关键词:关联;糖尿病视网膜病变;前馈控制;健康教育;自我感觉负担;视觉功能。
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引用次数: 0
Lipid and nutritional profiles of Caribbean patients with chronic kidney disease 加勒比地区慢性肾病患者的脂质和营养状况
4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-10-11 DOI: 10.4314/ahs.v23i3.75
Saleh Idris
Aim: Chronic kidney disease (CKD) is marked by the deterioration of kidney function and derangement in lipid metabolism.Thus, we aim at evaluating the lipid and nutritional parameters of Caribbean patients with CKD. Methods: The study recruited 88 CKD patients and 105 apparently healthy subjects. Blood glucose, urea, creatinine, albumin,uric acid, total cholesterol, triglycerides, HDL-cholesterol, VLDL, and LDL were measured in duplicate on the Vitros 4600Multi-Channel Chemistry Auto-Analyzer (Johnson & Johnson Ortho-Clinical Diagnostics Inc., Rochester NY, USA) in our laboratory.The Statistical Package for the Social Sciences (SPSS, version 20) was used for statistical analysis. Results: Mean levels of diastolic blood pressure (p < 0.05), age, and systolic blood pressure between the patients and thehealthy controls (p < 0.001) were different. In addition, mean levels of BUN (p < 0.05), serum creatinine, and uric acid werehigher and eGFR lower in the patients compared with the healthy controls (p < 0.001). The mean levels of albumin, glucose,triglycerides, HDL-cholesterol, and VLDL (p < 0.001) also differed between patients and healthy controls. Negative correlationbetween eGFR and triglycerides and a positive correlation between eGFR and total cholesterol, HDL-c and LDL were observed.The prevalence of hypoalbuminemia, hypercholesterolemia and underweight were 27.27%, 57.95% and 4.55% respectively inpatients, compared with 10.48%, 44.74% and 2.86% respectively in healthy controls. Conclusion: Dyslipidemia is common in CKD patients and is therefore, imperative that, routine lipid profile analysis be detailedin order to check any trend towards the development of CVD. Keywords: Cardiovascular diseases; chronic kidney disease; dyslipidemia; estimated glomerular filtration rate; kidney; malnutrition;parameter; risk factor.
目的:慢性肾脏疾病(CKD)以肾功能恶化和脂质代谢紊乱为特征。因此,我们的目的是评估加勒比地区CKD患者的脂质和营养参数。方法:招募慢性肾病患者88例,表面健康者105例。血糖、尿素、肌酐、白蛋白、尿酸、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、VLDL和LDL在Vitros 4600多通道化学自动分析仪(Johnson &Johnson Ortho-Clinical Diagnostics Inc., Rochester NY, USA)。使用社会科学统计软件包(SPSS, version 20)进行统计分析。 结果:平均舒张压水平(p <0.05)、年龄和收缩压在患者和健康对照组之间的差异(p <0.001)。此外,BUN的平均水平(p <0.05),血清肌酐和尿酸高于健康对照组,eGFR低于健康对照组(p <0.001)。白蛋白、葡萄糖、甘油三酯、高密度脂蛋白胆固醇和VLDL的平均水平(p <0.001),患者和健康对照组之间也存在差异。eGFR与甘油三酯呈负相关,与总胆固醇、HDL-c和LDL呈正相关。住院患者低白蛋白血症、高胆固醇血症和体重过轻的患病率分别为27.27%、57.95%和4.55%,而健康对照组分别为10.48%、44.74%和2.86%;结论:血脂异常在CKD患者中很常见,因此,有必要进行详细的常规血脂分析,以检查CVD的发展趋势。 关键词:心血管疾病;慢性肾病;血脂异常;估计肾小球滤过率;肾脏;营养不良;参数;风险因素。
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引用次数: 0
Service delivery inaccessibility as a predictor of teenage pregnancy in South Africa 服务提供难及性作为南非少女怀孕的预测因子
4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-10-11 DOI: 10.4314/ahs.v23i3.9
Mkwanazi Sibusiso
Background: With the onset of the South African democracy in 1994 it was hoped that many social inequalities would beaddressed urgently. However, studies have shown that service delivery inaccessibility remains a challenge and investigating thesocial implications of such injustices remains important. Objective: This study determined to establish the association between service delivery inaccessibility and adolescent pregnancyin South Africa. Methods: Using data from 2019 and 2021 general household surveys, 7 737 teenage females were included. The study applieddescriptive statistics, chi-squared testing as well as multilevel binary logistic regression. Results: Random-intercept multilevel binary logistic regression revealed that the risk of adolescent pregnancy independently increased as the level of service inaccessibility increased at household level (no services: OR=1.73, 1 service: OR=1.40, 2 services:OR=1.28) and community level (medium: OR=1.22, high: OR=1.38) at a P-value of 0.05. Conclusion: Findings highlight the need to guarantee universal service delivery urgently not only for development, but also toprevent adolescent pregnancy. Furthermore, the findings present evidence of structural factors driving adolescent pregnancy inSouth Africa, which renders continued cycles of poverty, injustice and early pregnancy amongst the majority of Blacks. Keywords: Teenage pregnancy; service inaccessibility; multilevel modelling; South Africa; structural inequality; teenagers.
背景:随着1994年南非民主的开始,人们希望能够紧急解决许多社会不平等问题。然而,研究表明,服务提供的无障碍仍然是一个挑战,调查这种不公正的社会影响仍然很重要。目的:本研究旨在确定服务提供难及性与南非青少年怀孕之间的关系。方法:利用2019年和2021年综合住户调查数据,纳入7 737名青少年女性。本研究采用描述性统计、卡方检验和多水平二元logistic回归。 结果:随机截获多水平二元logistic回归显示,青少年怀孕风险随家庭水平(无服务水平:OR= 1.73,有服务水平:OR= 1.40,有服务水平:OR=1.28)和社区水平(中等水平:OR= 1.22,高水平:OR= 1.38)的不可及性水平的增加而独立增加,p值为0.05。 结论:研究结果强调,迫切需要保证普遍提供服务,不仅是为了发展,也是为了预防青少年怀孕。此外,调查结果提供了南非青少年怀孕的结构性因素的证据,这使得大多数黑人持续处于贫困、不公正和早孕的循环之中。关键词:少女怀孕;服务无法理解;多级建模;南非;结构性的不平等;青少年。
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引用次数: 0
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African Health Sciences
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