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Salivary Diurnal Cortisol Predicts Post-Traumatic Stress Symptoms in Parents of Infants With Congenital Heart Disease. 唾液腺日皮质醇可预测先天性心脏病婴儿父母的创伤后应激症状
Pub Date : 2024-07-01 Epub Date: 2024-01-02 DOI: 10.1177/10998004231224791
Amy Jo Lisanti, Fanghong Dong, Abigail Demianczyk, Maria G Vogiatzi, Ryan Quinn, Jesse Chittams, Rebecca Hoffman, Barbara Medoff Cooper

Background: Parents of infants born with congenital heart disease (CHD) who require open heart surgery after birth are at risk for prolonged psychological distress. Even after their infants are discharged, parents may experience anxiety, depressive, and post-traumatic stress (PTS) symptoms; yet, it is unclear which parents are at greater risk for ongoing symptoms. The purpose of this study was to explore whether measures of the biomarker cortisol in parents during their infants' postoperative period were associated with subsequent psychological distress symptoms at three-month post discharge.

Methods: This was a prospective, longitudinal exploratory study of 40 parents of infants with CHD after open heart surgery using consecutive enrollment. Parents provided diurnal saliva samples for two consecutive days in the postoperative period. Six predictors were summarized and generated including waking cortisol, bedtime cortisol, cortisol awaking response, area under curve with respect to the ground (AUCg), cortisol index, and cortisol slope. Self-report outcome measures on anxiety, depressive, and PTS symptoms were collected three-months post-discharge. Linear mixed models examined the associations between each predictor and each outcome while accounting for within-dyad variance using an unstructured covariance matrix.

Results: Cortisol AUCg was a predictor of PTS at three-months post-discharge (β = .34, p = .03, Cohen's d = 2.05). No significant relationships were found with the other cortisol measures.

Conclusions & implications: Findings suggest that cortisol area under curve may help to identify parents at risk for increased PTS in the months following their infants' hospitalization for cardiac surgery, serving as a foundation for future study in this area.

背景:患有先天性心脏病(CHD)的婴儿出生后需要进行开胸手术,其父母面临长期心理困扰的风险。即使在婴儿出院后,父母仍可能出现焦虑、抑郁和创伤后应激(PTS)症状;然而,目前尚不清楚哪些父母出现持续症状的风险更大。本研究旨在探讨婴儿术后期间父母体内生物标志物皮质醇的测量结果是否与出院三个月后的心理困扰症状有关:这是一项前瞻性纵向探索性研究,采用连续入组的方式,对40名接受过开放性心脏手术的患有先天性心脏病的婴儿的父母进行研究。家长在术后连续两天提供唾液样本。我们总结并生成了六个预测因子,包括清醒皮质醇、睡前皮质醇、皮质醇觉醒反应、相对于地面的曲线下面积(AUCg)、皮质醇指数和皮质醇斜率。出院后三个月收集焦虑、抑郁和创伤后应激反应症状的自我报告结果。线性混合模型检验了每个预测因子与每个结果之间的关联,同时使用非结构化协方差矩阵考虑了日内方差:结果:皮质醇 AUCg 是出院后三个月 PTS 的预测因子(β = .34,p = .03,Cohen's d = 2.05)。结论和影响:研究结果表明,皮质醇曲线下面积可能有助于识别婴儿因心脏手术住院后几个月内PTS增加风险的父母,为今后该领域的研究奠定基础。
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引用次数: 0
Relationship Between Sleep Duration and Cognitive Function in Older Adults: Analysis of NHANES and UK Biobank GWAS Data. 老年人睡眠时间与认知功能之间的关系:NHANES和英国生物库GWAS数据分析。
Pub Date : 2024-07-01 Epub Date: 2024-02-01 DOI: 10.1177/10998004241230325
Min Yu, Yang Jiang, Xu Gong, Xuemei Gao

Objectives: To explore the relationship between sleep duration and cognitive functions in older adults using NHANES, a national US population study dataset, and to explore the causal association with Mendelian randomization (MR) using the UK Biobank.

Methods: First, an observational study was conducted with the NHANES database with participants ≥60 years. Sleep duration was measured with accelerometers for 7 consecutive days. Participants were divided into habitual short sleep (<7 h) and long sleep (>9 h) groups. Cognitive functions were measured with the CERAD Word Learning sub-set, Animal Fluency, and Digit Symbol Substitution test (DSST). Multivariate regression models were used to explore relationships between sleep duration and cognitive functions. Second, bidirectional MR was conducted with data for self-reported sleep duration, which came from a genome-wide association study (GWAS) comprising 446,118 adults from the UK Biobank, and general cognitive performance, which was obtained from a recent GWAS study (N = 257,841). Inverse-variance weighted (IVW) was used as the primary estimation of the outcome.

Results: In the observational study, 2687 participants were included. Sleep duration was associated with cognitive functions in a non-linear way. Habitual long sleep (>9°h) was associated with lower scores on DSST (OR = 0.01, p = .003) in the fully-adjusted model. The association between habitual short sleep and cognitive functions was insignificant. For the MR, genetically predicted lower general cognitive performance was causally associated with a higher prevalence of habitual short sleep (OR = 0.97, p = 5.1 × 10-7) and long sleep (OR = 0.97, p = 8.87 × 10-16).

Discussion: Short and long sleep duration might be both causally associated with worse outcomes of cognitive functions in older adults, highlighting the importance of maintaining sleep health.

目的:利用美国全国人口研究数据集 NHANES 探讨老年人睡眠时间与认知功能之间的关系,并利用英国孟德尔随机化(MR)探讨两者之间的因果关系:利用美国全国人口研究数据集 NHANES 探讨老年人睡眠时间与认知功能之间的关系,并利用英国生物库探讨与孟德尔随机化(MR)的因果关系:首先,利用 NHANES 数据库对年龄≥60 岁的参与者进行观察研究。连续 7 天使用加速度计测量睡眠时间。参与者被分为习惯性短睡眠(9 小时)组。认知功能通过 CERAD 单词学习子集、动物语言流畅性和数字符号替换测试(DSST)进行测量。采用多元回归模型探讨睡眠时间与认知功能之间的关系。其次,利用自我报告的睡眠时间数据和一般认知能力数据进行了双向磁共振分析,自我报告的睡眠时间数据来自一项全基因组关联研究(GWAS),该研究包括英国生物库中的 446 118 名成年人,而一般认知能力数据则来自最近的一项 GWAS 研究(N = 257 841)。结果显示,反方差加权(IVW)是对结果的主要估计:结果:这项观察性研究共纳入了 2687 名参与者。睡眠时间与认知功能呈非线性关系。在完全调整模型中,习惯性长睡眠(>9°h)与DSST得分较低有关(OR = 0.01,p = .003)。习惯性短时睡眠与认知功能之间的关系并不显著。就 MR 而言,遗传预测的较低一般认知能力与较高的习惯性短睡眠(OR = 0.97,p = 5.1 × 10-7)和长睡眠(OR = 0.97,p = 8.87 × 10-16)有因果关系:讨论:睡眠时间短和睡眠时间长可能都与老年人认知功能较差的结果有因果关系,这凸显了保持睡眠健康的重要性。
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引用次数: 0
Factors Associated With the Cardiovascular Health of Black and Latino Adults With Type 2 Diabetes. 与患有 2 型糖尿病的黑人和拉丁裔成年人心血管健康有关的因素。
Pub Date : 2024-07-01 Epub Date: 2024-03-06 DOI: 10.1177/10998004241238237
Margaret M McCarthy, Jason Fletcher, Fay Wright, Inés Del Giudice, Agnes Wong, Bradley E Aouizerat, Victoria Vaughan Dickson, Gail D'Eramo Melkus

Aims: The purpose of this study was to assess the levels of cardiovascular health (CVH) of Black and Latino adults with type 2 diabetes (T2D) and examine the association of individual and microsystem level factors with their CVH score.

Methods: This was a cross-sectional design in 60 Black and Latino Adults aged 18-40 with T2D. Data were collected on sociodemographic, individual (sociodemographic, diabetes self-management, sleep disturbance, depressive symptoms, quality of life, and the inflammatory biomarkers IL-6 and hs-CRP) and microsystem factors (family functioning), and American Heart Association's Life's Simple 7 metrics of CVH. Factors significantly associated with the CVH score in the bivariate analyses were entered into a linear regression model.

Results: The sample had a mean age 34 ± 5 years and was primarily female (75%) with a mean CVH score was 8.6 ± 2.2 (possible range of 0-14). The sample achieved these CVH factors at ideal levels: body mass index <25 kg/m2 (8%); blood pressure <120/80 (42%); hemoglobin A1c < 7% (57%); total cholesterol <200 mg/dL (83%); healthy diet (18%); never or former smoker > one year (95%); and physical activity (150 moderate-to-vigorous minutes/week; 45%). In the multivariable model, two factors were significantly associated with cardiovascular health: hs-CRP (B = -0.11621, p < .0001) and the general health scale (B = 0.45127, p = .0013).

Conclusions: This sample had an intermediate level of CVH, with inflammation and general health associated with overall CVH score.

目的:本研究的目的是评估患有 2 型糖尿病(T2D)的黑人和拉丁裔成年人的心血管健康(CVH)水平,并研究个人和微系统水平因素与其 CVH 分数之间的关联:这是一项横断面设计,研究对象为 60 名患有 2 型糖尿病的 18-40 岁黑人和拉丁裔成年人。收集的数据包括社会人口学、个体因素(社会人口学、糖尿病自我管理、睡眠障碍、抑郁症状、生活质量、炎症生物标志物 IL-6 和 hs-CRP)和微观系统因素(家庭功能),以及美国心脏协会的 "简单生活 "7 项 CVH 指标。将双变量分析中与 CVH 评分明显相关的因素输入线性回归模型:样本的平均年龄为 34 ± 5 岁,主要为女性(75%),平均 CVH 得分为 8.6 ± 2.2(可能范围为 0-14)。样本的这些 CVH 因素达到了理想水平:体重指数 2(8%);一年血压(95%);体育锻炼(每周 150 分钟中度至剧烈运动;45%)。在多变量模型中,有两个因素与心血管健康显著相关:hs-CRP(B = -0.11621,p < .0001)和一般健康量表(B = 0.45127,p = .0013):该样本的心血管健康状况处于中等水平,炎症和总体健康状况与心血管健康状况总分相关。
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引用次数: 0
Risk Factors Analysis and Pathogen Distribution of Urinary Tract Infection in Patients Undergoing Cutaneous Ureterostomy After Radical Cystectomy for Bladder Cancer. 膀胱癌根治性切除术后接受皮下输尿管造口术患者尿路感染的风险因素分析和病原体分布
Pub Date : 2024-07-01 Epub Date: 2024-01-09 DOI: 10.1177/10998004241226948
Mu-Rong Zhu, Han-Xia Hong, Jing-Ru Cheng, Jing Tang, Tong Lu, Rui Xie

Background: Postoperative urinary tract infection is a common complication that not only significantly prolongs the hospital stay and amplifies the economic burden on patients, but also affects their quality of life and prognosis. This study aimed to investigate risk factors and distribution of pathogenic bacteria in urinary tract infections among bladder cancer patients who underwent cutaneous ureterostomy following radical cystectomy.

Methods: A total of 137 bladder cancer patients, who underwent cutaneous ureterostomy after radical cystectomy at our hospital from November 2018 to October 2022, were enrolled in this retrospective study. Univariate and multivariate logistic regression analyses were employed to investigate the risk factors associated with postoperative urinary tract infection and the distribution of pathogenic bacteria among the infected patients.

Results: The results of both univariate and multivariate analyses confirmed that age, proficiency in ostomy knowledge, frequency of ureteral stent tube replacement, ureteral stent tube dislodgement, urine immersion at the outer end of the ureteral stent tube, and the interval of ostomy bag replacement were independent risk factors for urinary tract infection after radical cystectomy and cutaneous ureterostomy in bladder cancer patients. A total of 55 pathogenic bacteria were isolated from 52 patients with infections. Predominantly, these were gram-negative bacteria (34 strains, 61.8%), with Proteus mirabilis having the highest proportion.

Conclusion: Urinary tract infections after radical cystectomy and cutaneous ureterostomy predominantly involve gram-negative bacteria. This is correlated with factors such as the age of bladder cancer patients, the level of nursing education, the duration of ureteral stent tubes and ostomy bag usage, as well as issues related to impaired urine drainage.

背景:术后尿路感染是一种常见的并发症,不仅会大大延长住院时间,加重患者的经济负担,还会影响患者的生活质量和预后。本研究旨在调查根治性膀胱切除术后接受经皮输尿管造口术的膀胱癌患者发生尿路感染的危险因素和致病菌分布情况:本回顾性研究共纳入了137例膀胱癌患者,这些患者于2018年11月至2022年10月在我院接受根治性膀胱切除术后接受了经皮输尿管造口术。采用单变量和多变量逻辑回归分析研究与术后尿路感染相关的风险因素以及感染患者中致病菌的分布情况:单变量和多变量分析结果证实,年龄、造口知识熟练程度、输尿管支架管更换频率、输尿管支架管脱落、输尿管支架管外端的尿液浸泡以及造口袋更换间隔时间是膀胱癌根治性膀胱切除术和皮肤输尿管造口术后尿路感染的独立危险因素。从 52 名感染患者体内共分离出 55 种致病细菌。这些细菌主要是革兰氏阴性菌(34 株,61.8%),其中变形杆菌所占比例最高:结论:根治性膀胱切除术和皮下输尿管造口术后的尿路感染主要涉及革兰氏阴性菌。这与膀胱癌患者的年龄、护理教育水平、使用输尿管支架管和造口袋的时间以及尿液引流受阻等因素有关。
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引用次数: 0
Role of Oxidative Stress and DNA Damage on Preterm Birth Outcome. 氧化应激和 DNA 损伤对早产结果的影响
Pub Date : 2024-07-01 Epub Date: 2024-02-01 DOI: 10.1177/10998004241230638
Pratibha Rathod, Ajesh Desai, Divya Chandel

Background: Preterm birth (PTB) poses a significant global health challenge and focused research is vital for improving maternal and neonatal health outcomes. The purpose of this study was to determine the effect of oxidative stress (OS) and DNA damage on PTB. Methods: There were two groups: (a) cases consisting of mothers with PTB (<37 weeks of gestation, n = 100) and (b) controls consisting of mothers with term birth (>37 weeks of gestation, n = 100). Women with vaginal infection, non-cephalic presentation, multiple gestations, fetal anomalies, Cesarean delivery, pregnancy with Mullerian anomalies, or preeclampsia were excluded from the study. OS analysis was conducted by measuring levels of superoxide dismutase (SOD), catalase (CAT), lipid peroxidation (LPO), and total protein and DNA damage were evaluated by CBMN-Cyt assay. Statistical analysis was performed using students' t-test and one-way ANOVA. Results: Low levels of antioxidants SOD and CAT (p < .0001), and total protein (p < .0001), besides high malondialdehyde (byproduct of LPO) (p < .0001) were observed in the PTB group. Moreover, high frequencies of micronuclei (p < .0001) and nucleoplasmic buds (p < .01) were detected in the PTB mothers compared to term birth mothers, while no significance was observed in the nucleoplasmic bridge frequencies. Conclusion: When the body's immune system and antioxidants fail to cope up with the generated OS, it can lead to PTB. Along with other body tests, OS markers and CBMN-Cyt tests have the potential to be used in diagnostics for early warning as well as monitoring and advising mothers for a better pregnancy outcome.

背景:早产(PTB)对全球健康构成了重大挑战,而重点研究对于改善孕产妇和新生儿的健康状况至关重要。本研究旨在确定氧化应激(OS)和 DNA 损伤对早产的影响。研究方法分为两组:(a) 患有先天性肺结核的产妇(100 人);(b) 对照组,包括足月产(妊娠大于 37 周,100 人)的产妇。患有阴道感染、非头畸形、多胎妊娠、胎儿畸形、剖宫产、穆勒氏畸形妊娠或子痫前期的妇女不在研究范围内。通过测量超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、脂质过氧化物(LPO)和总蛋白水平进行OS分析,并通过CBMN-Cyt检测法评估DNA损伤。统计分析采用学生 t 检验和单因素方差分析。结果在 PTB 组中,除了丙二醛(LPO 的副产物)含量高(p < .0001)外,抗氧化剂 SOD 和 CAT 含量低(p < .0001),总蛋白含量低(p < .0001)。此外,与足月分娩的母亲相比,PTB 母亲中检测到的微核(p < .0001)和核质芽(p < .01)的频率较高,而核质桥的频率则无显著性差异。结论当人体的免疫系统和抗氧化剂无法应对产生的操作系统时,就会导致先天性脑瘫。OS标记和CBMN-Cyt检测与其他身体检测一样,都有可能用于诊断早期预警以及监测和建议母亲改善妊娠结局。
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引用次数: 0
Factors Associated With Fatigue in Persons With Atrial Fibrillation in the Atherosclerosis Risk in Communities (ARIC) Study. 社区动脉粥样硬化风险(ARIC)研究中心房颤动患者疲劳的相关因素。
Pub Date : 2024-07-01 Epub Date: 2024-01-02 DOI: 10.1177/10998004231225442
Kathryn A Wood, Aniqa B Alam, Lin Yee Chen, Elsayed Z Soliman, Arshed A Quyyumi, Alvaro Alonso

Background: Atrial fibrillation (AF) is a common cardiac arrhythmia affecting over 6 million people in the U.S. Fatigue is a frequent symptom of AF, yet no underlying biological mechanisms have been identified in AF-related fatigue as in other chronic conditions such as cancer or HIV fatigue (inflammation, tissue injury). We aimed to identify biomarkers and correlates of AF-fatigue in ARIC participants.

Methods: Participants with AF from ARIC visit 5 (2011-2013) were included in the study. Multiple linear regression was used to estimate the association of high sensitivity troponin (hs-TnT), N-terminal fragment B-type natriuretic peptide (NT-proBNP) and high sensitivity C-reactive protein (hsCRP) levels with self-reported fatigue (SF-12 and PROMIS Fatigue Scale), depressive symptoms (Center for Epidemiological Studies Depression survey), and physical functioning (Short Physical Performance Battery) scores. All biomarkers underwent natural-log transformation.

Results: There were 446 participants (mean age: 78 y ± 5; 44% women). In adjusted analyses, NT-proBNP was associated with AF-fatigue (β: 0.11, 95% CI: 0.03, 0.19), increased depressive symptoms (β: 0.44, 95% CI: 0.19, 0.70), and decreased physical function (β: -0.48, 95% CI: -0.72, -0.23). Hs-TnT was also associated with elevated AF-fatigue (β: 0.24, 95% CI: 0.09, 0.39) along with decreased physical function (β: -1.19, 95% CI: -1.64, -0.75). No significant associations were found with hsCRP and fatigue.

Conclusion: Increased levels of cardiac injury biomarkers, depressive symptoms, and decreased physical function were associated with AF-fatigue. Inflammation was not associated with AF-fatigue; other physiological pathways, such as cardiac overload or myocardial injury may be more relevant in AF-fatigue.

背景:疲劳是心房颤动的常见症状,但与癌症或艾滋病疲劳(炎症、组织损伤)等其他慢性病一样,尚未发现心房颤动相关疲劳的潜在生物学机制。我们的目的是在急性心房颤动综合征参与者中确定心房颤动疲劳的生物标志物和相关因素:研究纳入了第 5 次(2011-2013 年)ARIC 访问中的房颤参与者。采用多元线性回归估算高敏肌钙蛋白(hs-TnT)、N-末端片段 B 型钠尿肽(NT-proBNP)和高敏 C 反应蛋白(hsCRP)水平与自我报告的疲劳(SF-12 和 PROMIS 疲劳量表)、抑郁症状(流行病学研究中心抑郁调查)和身体功能(短期体能测试)评分之间的关系。所有生物标志物均经过自然对数转换:共有 446 名参与者(平均年龄:78 岁 ± 5;44% 为女性)。在调整分析中,NT-proBNP 与房颤疲劳(β:0.11,95% CI:0.03,0.19)、抑郁症状增加(β:0.44,95% CI:0.19,0.70)和身体功能下降(β:-0.48,95% CI:-0.72,-0.23)相关。Hs-TnT 也与房颤疲劳升高(β:0.24,95% CI:0.09,0.39)和身体功能下降(β:-1.19,95% CI:-1.64,-0.75)有关。结论:心脏损伤生物标志物水平的升高与身体功能的下降(β:-1.19,95% CI:-1.64,-0.75)无明显关联:结论:心脏损伤生物标志物水平升高、抑郁症状和身体功能下降与房颤-疲劳有关。炎症与房颤疲劳无关;其他生理途径,如心脏负荷过重或心肌损伤可能与房颤疲劳更相关。
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引用次数: 0
Gut Microbiota and Symptom Expression and Severity in Neonatal Abstinence Syndrome. 肠道微生物群与新生儿戒断综合征的症状表现和严重程度。
Pub Date : 2024-07-01 Epub Date: 2024-03-26 DOI: 10.1177/10998004241242102
Stephanie Sealschott, Rita Pickler, Christine Fortney, Michael Bailey, Brett Loman

Problem: Neonatal abstinence syndrome (NAS) affecting neonates with fetal exposure to opioids, is defined by expression and severity of symptoms. The pathophysiology behind symptoms variability is lacking. The study aims were to examine (a) differences in gut microbiota of neonates with and without NAS, (b) the relationships between gut microbiota and symptom expression and NAS severity, and (c) the changes in the neonate gut microbiota diversity during the course of NAS treatment. Methods: A cross-sectional observational design was used to examine differences in microbiota and a longitudinal, repeated measures approach was used to determine relationships between gut microbiota and NAS symptoms. Symptom data were collected using the Finnegan Neonatal Abstinence Scoring Tool and the Neonatal Pain Agitation and Sedation Scale. Stool samples were collected for microbiome analyses with 16S rRNA microbiome sequencing. Results: Differences in alpha and beta diversity between neonates with and without NAS were seen. Relative abundance results revealed 18 taxa were different in neonates with NAS compared to neonates without NAS. No differences were found in alpha or beta diversity in neonates with NAS between enrollment and hospital discharge. There was increased abundance of Escherichia-Shigella and Bacteriodes genera related to higher symptom scores. Discussion: Differences in alpha and beta diversity between neonates with and without NAS may be due to differences in birth mode and type of feeding. The findings of specific increased bacteria related to increased symptoms in the neonates with NAS may also be influenced by birth mode and type of feeding.

问题:新生儿禁欲综合征(NAS)影响胎儿暴露于阿片类药物的新生儿,根据症状的表现和严重程度来定义。目前尚缺乏症状变化背后的病理生理学。本研究旨在探讨:(a) 患有和未患 NAS 的新生儿肠道微生物群的差异;(b) 肠道微生物群与症状表现和 NAS 严重程度之间的关系;(c) 在治疗 NAS 的过程中新生儿肠道微生物群多样性的变化。研究方法采用横断面观察设计研究微生物群的差异,采用纵向重复测量方法确定肠道微生物群与 NAS 症状之间的关系。使用芬尼根新生儿戒断评分工具和新生儿疼痛躁动与镇静量表收集症状数据。收集的粪便样本通过 16S rRNA 微生物组测序进行微生物组分析。结果患有和未患有 NAS 的新生儿在 alpha 和 beta 多样性方面存在差异。相对丰度结果显示,与未患 NAS 的新生儿相比,患 NAS 的新生儿中有 18 个分类群不同。患有 NAS 的新生儿在入院和出院期间的阿尔法和贝塔多样性均无差异。埃希氏菌属(Escherichia-Shigella)和杆菌属(Bacteriodes)的丰度增加与症状评分较高有关。讨论:患有和未患有 NAS 的新生儿在阿尔法和贝塔多样性方面的差异可能是由于出生方式和喂养类型的不同造成的。在患有 NAS 的新生儿中,与症状增加有关的特定细菌增加的发现也可能受到出生方式和喂养类型的影响。
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引用次数: 0
Auricular Acupressure Improve Constipation of Patients With Schizophrenia: A Pilot Randomized Controlled Study. 耳穴指压法改善精神分裂症患者的便秘:随机对照试验研究》。
Pub Date : 2024-07-01 Epub Date: 2024-03-04 DOI: 10.1177/10998004241236947
Ciao-Min Gong, Hui-Chuan Huang, Ju-Han Liu, Shiou-Shiun Yu, Yu-Ting Chen

Background. Constipation is a common distressing problem in patients with schizophrenia that can cause complications and impair quality of life. Objective. The objective of this study was to investigate the efficacy of applying auricular acupressure (AA) treatment in improving constipation in patients with schizophrenia. Methods. A crossover randomized controlled trial design was performed from April 2022 to December 2023 at four psychiatric rehabilitation care centers. A total of 23 patients with schizophrenia received an AA intervention or usual care according to the designated treatment sequences. Measurements comprised subjective assessment of constipation by the Patient Assessment of Constipation-Symptoms (PAC-SYM) questionnaire, an objective assessment of the stool pattern rated by a Bristol stool form scale, and heart rate variability. A generalized estimating equation model was used for data analyses. Results. After completing an 8-week AA intervention stimulating the Shenmen, San Jiao, Large intestine and Rectum, the AA group exhibited lower scores in the PAC-SYM total score (difference = -12.66, ,0.001), and the subscales: abdominal (difference = -3.36, p < .001), rectal (difference = -3.51, p < .001), and stool (difference = -5.79, p < .001), compared to those receiving usual care. The cases of constipation indicated by type 1 and type 2 of the BSF scale significantly decreased after the 8-week AA intervention. Moreover, the AA group displayed more parasympathetic dominance compared to the usual care group, with a low frequency to high frequency ratio of -1.15. Conclusion. AA is an effective non-pharmacological method for improving subjective constipation symptoms and objective stool pattern in patients with schizophrenia.

背景。便秘是精神分裂症患者常见的困扰,可引起并发症并影响生活质量。研究目的本研究旨在探讨耳穴贴压疗法(AA)对改善精神分裂症患者便秘的疗效。研究方法2022年4月至2023年12月,在四家精神康复护理中心进行了交叉随机对照试验。共有23名精神分裂症患者按照指定的治疗顺序接受了AA干预或常规护理。测量包括通过便秘患者症状评估(PAC-SYM)问卷对便秘进行的主观评估、通过布里斯托粪便形态量表对粪便形态进行的客观评估以及心率变异性。数据分析采用了广义估计方程模型。研究结果在完成为期 8 周的刺激神门、三焦、大肠和直肠的 AA 干预后,与接受常规护理的患者相比,AA 组的 PAC-SYM 总分(差异 = -12.66,P.001)以及腹部(差异 = -3.36,P.001)、直肠(差异 = -3.51,P.001)和大便(差异 = -5.79,P.001)等分量表的得分均较低。在接受为期 8 周的 AA 干预后,BSF 量表第 1 和第 2 类显示的便秘病例明显减少。此外,与常规护理组相比,AA 组显示出更多的副交感神经支配,低频率与高频率之比为 -1.15。结论:AA 是一种有效的非药物疗法。AA 是一种有效的非药物治疗方法,可改善精神分裂症患者的主观便秘症状和客观粪便形态。
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引用次数: 0
Impact of SARS-COV-2 Infection on Maternal, Obstetric and Neonatal Outcomes in a Cohort of Vaccinated Women: A Pilot Study. SARS-COV-2 感染对已接种疫苗的产妇、产科和新生儿预后的影响:一项试点研究。
Pub Date : 2024-07-01 Epub Date: 2024-03-01 DOI: 10.1177/10998004241237134
María Cruz-Calvente, Blanca Rueda-Medina, Rocío Gil-Gutiérrez, Irene Medina-Martínez, José L Gómez-Urquiza, María Correa-Rodríguez

We aimed to investigate the impact of COVID-19 infection on maternal characteristics and obstetric and neonatal outcomes in a cohort of women in labor previously vaccinated who tested positive for SARS-CoV-2 infection, compared to aged-matched healthy controls. A retrospective case-control study was conducted among 66 women in labor. Clinical data were obtained from medical records. The attendance rates at childbirth and parenting classes, as well as the implementation of a birth plan, were significantly lower in the COVID-19 infection group (6.1% vs. 48.5%, <0.001; 6.1% vs. 33.3%, p = .005, respectively). Women with COVID-19 had a higher prevalence of prolonged postpartum hospital stay (33.3% vs. 9.1%, p = .016), and significantly higher prevalence of spontaneous preterm birth (27.3% vs. 1.09%, p = .006). Breastfeeding within the first 24 hr was also lower in women with COVID-19 (72.7% vs. 97.0%, p = .006). Maternal characteristics and neonatal outcomes are influenced by COVID-19 infection in vaccinated women. Complications include spontaneous preterm birth, prolonged postpartum hospital stay, and lack of breastfeeding within the first 24 hr. Childbirth education, parenting classes and implementing a birth plan may be associated with a decreased risk of COVID-19 infection.

我们的目的是研究 COVID-19 感染对产妇特征、产科和新生儿预后的影响,研究对象是曾接种过疫苗、SARS-CoV-2 感染检测呈阳性的产妇,并与年龄匹配的健康对照组进行了比较。该研究对 66 名产妇进行了回顾性病例对照研究。临床数据来自医疗记录。感染 COVID-19 的产妇参加分娩和育儿课程的比率以及实施分娩计划的比率明显较低(分别为 6.1% 与 48.5%,p = .005)。感染 COVID-19 的妇女产后住院时间延长的比例更高(33.3% 对 9.1%,p = .016),自然早产的比例也明显更高(27.3% 对 1.09%,p = .006)。患有 COVID-19 的产妇在最初 24 小时内的母乳喂养率也较低(72.7% vs. 97.0%,p = .006)。接种疫苗的妇女感染 COVID-19 会影响产妇特征和新生儿预后。并发症包括自然早产、产后住院时间延长以及在头 24 小时内缺乏母乳喂养。分娩教育、育儿课程和分娩计划的实施可能与 COVID-19 感染风险的降低有关。
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引用次数: 0
Mediating Effect of White Blood Cells and Tobacco Exposure on Cervical Neoplasm Risk Among Taiwanese Women. 白细胞和烟草接触对台湾女性宫颈癌风险的中介效应
Pub Date : 2024-07-01 Epub Date: 2024-01-25 DOI: 10.1177/10998004241229069
Ya Wen Shih, Ching Wen Chang, Hui-Chen Rita Chang, Jia Ruey Tsai, Wei-Jun Wang, Hui Fen Fang, Chia Ling Lin, Yohanes Andy Rias, Hsiu Ting Tsai

Background: Both the high-risk human papillomavirus (HR-HPV) infection and tobacco exposure are significantly associated with cervical neoplasm risk. Immune cells play important roles in carcinogenesis. However, it is still unclear whether immune cells have a mediating effect on the HR-HPV infection and tobacco exposure with cervical neoplasm development. Aim: The aim of this study was to determine how the increased white blood cell (WBC) count affects the relationship between HR-HPV DNA load and tobacco exposure in the development of cervical neoplasia. Methods: A hospital-based case-control study design was conducted with a total of 108 cases of Taiwanese women with ≥ cervical intraepithelial neoplasia (CIN) I confirmed by biopsy, and 222 healthy Taiwanese female subjects with negative findings on a Pap smear were assigned to the control group. The study evaluated HR-HPV status and immune cell counts (WBCs, natural killer (NK) cells) and tobacco exposure by a self-construct questionnaire. Results: Both HR-HPV DNA load and tobacco exposure significantly independently increased cervical neoplasm risk (AORs: 1.28 and 1.42, respectively). Similar significant results were found for WBCs and NK cells, with respective AORs of 1.20 and 1.00. Moreover, increased WBCs (β = 0.04, 95% CI corrected: 0.01-0.07) and tobacco exposure (β = 0.02, 95% CI corrected: 0.01-0.04) mediated the relationship between the high-risk HPV DNA load and cervical neoplasm risk. Conclusions: Elevated WBC count acts as both predictor and mediator in cervical neoplasm development linked to HR-HPV DNA load. Monitoring and maintaining WBC levels within the normal range could be a preventive strategy for cervical neoplasm development.

背景:高危人乳头状瘤病毒(HR-HPV)感染和烟草接触都与宫颈肿瘤风险密切相关。免疫细胞在致癌过程中发挥着重要作用。然而,免疫细胞是否对 HR-HPV 感染和烟草暴露与宫颈肿瘤发生有中介作用,目前仍不清楚。目的:本研究旨在确定白细胞(WBC)数量的增加如何影响 HR-HPV DNA 负荷与烟草暴露在宫颈肿瘤发生中的关系。研究方法采用医院病例对照研究设计,将经活检证实≥宫颈上皮内瘤变(CIN)Ⅰ的108例台湾女性和巴氏涂片结果为阴性的222例健康台湾女性分为对照组。研究通过自编问卷评估了HR-HPV状态、免疫细胞计数(白细胞、自然杀伤(NK)细胞)和烟草接触情况。研究结果HR-HPV DNA 负荷和烟草接触均显著增加了宫颈肿瘤风险(AORs:分别为 1.28 和 1.42)。白细胞和 NK 细胞也有类似的显着结果,AORs 分别为 1.20 和 1.00。此外,白细胞增加(β = 0.04,95% CI 校正值:0.01-0.07)和烟草暴露(β = 0.02,95% CI 校正值:0.01-0.04)介导了高危 HPV DNA 负载与宫颈肿瘤风险之间的关系。结论白细胞计数升高既是宫颈肿瘤发生的预测因子,也是与高危型 HPV DNA 负载相关的中介因子。监测白细胞水平并将其维持在正常范围内可作为宫颈肿瘤发生的预防策略。
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引用次数: 0
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Biological research for nursing
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