目的探究剖宫产瘢痕妊娠孕妇清宫术大出血的影响因素,并进行风险评估。方法纳入2021年3月至2023年3月在温州医科大学附属第一医院收治的98例接受清宫术治疗的剖宫产瘢痕妊娠孕妇,根据术中出血量分组:大出血组(出血量≥400 mL,28例),对照...目的探究剖宫产瘢痕妊娠孕妇清宫术大出血的影响因素,并进行风险评估。方法纳入2021年3月至2023年3月在温州医科大学附属第一医院收治的98例接受清宫术治疗的剖宫产瘢痕妊娠孕妇,根据术中出血量分组:大出血组(出血量≥400 mL,28例),对照组(出血量≤400 m L,70例),比较组间临床指标差异,探究影响患者术中大出血发生的影响因素,并建立预测模型,探究该模型对患者发生大出血的预测效能。结果剖宫产次数、病灶绒毛膜距浆膜层最近距离、丛密绒毛膜厚度、病灶长径、血流分级、病灶突入切口的平均径均会影响术中大出血的发生,据此建立预测模型,该预测模型预测患者术中大出血发生的曲线下面积(area under the curve,AUC)值为0.901,95%CI为0.805~0.997,敏感度为0.917,特异度为0.810(P<0.05)。结论接受清宫术治疗的剖宫产瘢痕妊娠孕妇术中大出血发生与其剖宫产次数、病灶绒毛膜距浆膜层最近距离、丛密绒毛膜厚度、病灶突入切口的平均径、病灶长径、血流分级存在一定联系,基于此构建的模型具有较好的预测价值。展开更多
为了调查与抗逆转录病毒治疗(antiretroviral therapy,ART)相关的静息状态功能连接的动态特性,从45名接受治疗的HIV感染者(people with HIV,PWH)、56名未接受治疗的PWH与68名健康对照者采集得到功能磁共振成像数据.使用组独立成分分析...为了调查与抗逆转录病毒治疗(antiretroviral therapy,ART)相关的静息状态功能连接的动态特性,从45名接受治疗的HIV感染者(people with HIV,PWH)、56名未接受治疗的PWH与68名健康对照者采集得到功能磁共振成像数据.使用组独立成分分析、滑动窗分析提取窗功能连接矩阵及量化其动态特性.结果表明,基线状态、弱激活状态体现了HIV相关异常动态及ART相关恢复,弱激活状态体现小脑相关连接恢复、壳核相关功能代偿,基线状态体现除视觉网络外的广泛网络连接恢复.视觉相关连接在两种状态中均体现为ART相关的不良反应.这些发现表明小脑、壳核可能是ART相关恢复的敏感生物标志物,视觉网络可作为辅助治疗的目标.展开更多
Background: HIV/AIDS is a pandemic disease and its scourge has had a devastating impact on health, nutrition, food security and overall socioeconomic development in affected countries. Moreover, intervention programme...Background: HIV/AIDS is a pandemic disease and its scourge has had a devastating impact on health, nutrition, food security and overall socioeconomic development in affected countries. Moreover, intervention programmes, which simply employ antiretroviral drugs, have been found to lack effectiveness particularly when the patient is under-nourished. Aim and Purpose: This presented pilot intervention provides evidence that suggests use of local resources as therapeutic nutrition. This can act as a fundamental part of the comprehensive package of care at the country level. Methodology: Local ingredients, which were known for their availability, accessibility, micro and macro-nutrient strengths were selected and optimised into a nutritional functional meal (Amtewa). Daily consumption was ascertained to assess its effects on nutritional status and biomedical indices of the study participants (n = 100) who were/were not taking Highly Active Anti-retroviral Therapy (HAART). Findings: Mean CD4 count for ART-Test group at baseline and sixth months increased by 40.8 cells/mm3 while the ART-Control group decreased 18.12 cells/mm3. This positive outcome qualified Amtewa meal to the next phase of intervention (400 participants) to ascertain its effectiveness on health status of HIV infected subjects and appraise its position within the National Health Services framework as innovative approach to attenuate the progression of HIV to AIDS in Nigeria. Conclusion: Amtewa-based approach in HIV management is innovative, culturally relevant, reliable and requiring low technology in order to assure compliance, sustainability and cost effectiveness. Although the achieved results take the form of specific technology, it suggests that a prolong consumption of the intervention meal (Amtewa) will be suitable to sustain the gained improvements in MUAC and CD4 cell counts thereby slowing the progression of the disease.展开更多
文摘目的探究剖宫产瘢痕妊娠孕妇清宫术大出血的影响因素,并进行风险评估。方法纳入2021年3月至2023年3月在温州医科大学附属第一医院收治的98例接受清宫术治疗的剖宫产瘢痕妊娠孕妇,根据术中出血量分组:大出血组(出血量≥400 mL,28例),对照组(出血量≤400 m L,70例),比较组间临床指标差异,探究影响患者术中大出血发生的影响因素,并建立预测模型,探究该模型对患者发生大出血的预测效能。结果剖宫产次数、病灶绒毛膜距浆膜层最近距离、丛密绒毛膜厚度、病灶长径、血流分级、病灶突入切口的平均径均会影响术中大出血的发生,据此建立预测模型,该预测模型预测患者术中大出血发生的曲线下面积(area under the curve,AUC)值为0.901,95%CI为0.805~0.997,敏感度为0.917,特异度为0.810(P<0.05)。结论接受清宫术治疗的剖宫产瘢痕妊娠孕妇术中大出血发生与其剖宫产次数、病灶绒毛膜距浆膜层最近距离、丛密绒毛膜厚度、病灶突入切口的平均径、病灶长径、血流分级存在一定联系,基于此构建的模型具有较好的预测价值。
文摘为了调查与抗逆转录病毒治疗(antiretroviral therapy,ART)相关的静息状态功能连接的动态特性,从45名接受治疗的HIV感染者(people with HIV,PWH)、56名未接受治疗的PWH与68名健康对照者采集得到功能磁共振成像数据.使用组独立成分分析、滑动窗分析提取窗功能连接矩阵及量化其动态特性.结果表明,基线状态、弱激活状态体现了HIV相关异常动态及ART相关恢复,弱激活状态体现小脑相关连接恢复、壳核相关功能代偿,基线状态体现除视觉网络外的广泛网络连接恢复.视觉相关连接在两种状态中均体现为ART相关的不良反应.这些发现表明小脑、壳核可能是ART相关恢复的敏感生物标志物,视觉网络可作为辅助治疗的目标.
文摘Background: HIV/AIDS is a pandemic disease and its scourge has had a devastating impact on health, nutrition, food security and overall socioeconomic development in affected countries. Moreover, intervention programmes, which simply employ antiretroviral drugs, have been found to lack effectiveness particularly when the patient is under-nourished. Aim and Purpose: This presented pilot intervention provides evidence that suggests use of local resources as therapeutic nutrition. This can act as a fundamental part of the comprehensive package of care at the country level. Methodology: Local ingredients, which were known for their availability, accessibility, micro and macro-nutrient strengths were selected and optimised into a nutritional functional meal (Amtewa). Daily consumption was ascertained to assess its effects on nutritional status and biomedical indices of the study participants (n = 100) who were/were not taking Highly Active Anti-retroviral Therapy (HAART). Findings: Mean CD4 count for ART-Test group at baseline and sixth months increased by 40.8 cells/mm3 while the ART-Control group decreased 18.12 cells/mm3. This positive outcome qualified Amtewa meal to the next phase of intervention (400 participants) to ascertain its effectiveness on health status of HIV infected subjects and appraise its position within the National Health Services framework as innovative approach to attenuate the progression of HIV to AIDS in Nigeria. Conclusion: Amtewa-based approach in HIV management is innovative, culturally relevant, reliable and requiring low technology in order to assure compliance, sustainability and cost effectiveness. Although the achieved results take the form of specific technology, it suggests that a prolong consumption of the intervention meal (Amtewa) will be suitable to sustain the gained improvements in MUAC and CD4 cell counts thereby slowing the progression of the disease.
