presentation

介绍
  • 文章类型: Journal Article
    背景:眼神交流是最基本的人际交流形式之一。然而,到目前为止,目前还没有全面的研究比较如何在全球所有可能的人群中进行和解释眼神交流.这项研究总结了有关这些模式的现有文献,这些模式分为社会分类和精神疾病。
    方法:根据JoannaBriggsInstitute(JBI)方法对文献进行批判性评估的范围审查。数据库AnthroSource,Medline,CINAHL,搜索了心理学与行为科学收藏(EBSCO)和PsychInfo。
    结果:从灰色文献和参考列表中筛选了7068篇文章,其中包括385个,282用于社会分类,103用于精神疾病。总的来说,包括603个主题分类的变异结果。方法学质量一般为中等至良好。
    结论:人群之间和人群内部的眼神交流的表现和解释存在很大程度的差异。尚不清楚为什么在人群中会发生特定的变化。此外,研究中没有出现应如何使用或解释眼神交流的金标准.建议进一步研究人群之间和内部眼神接触差异的原因。
    BACKGROUND: Eye contact is one of the most fundamental forms of interhuman communication. However, to date, there has been no comprehensive research comparing how eye contact is made and interpreted in all possible populations worldwide. This study presents a summary of the existing literature on these modalities stratified to social categorizations and psychiatric disorders.
    METHODS: A scoping review with critical appraisal of the literature according to the Joanna Briggs Institute (JBI) methodology. Databases AnthroSource, Medline, CINAHL, the Psychology and Behavioral Sciences Collection (EBSCO) and PsychInfo were searched.
    RESULTS: 7068 articles were screened for both the grey literature and reference lists, of which 385 were included, 282 for social categorizations and 103 for psychiatric disorders. In total, 603 thematic clustered outcomes of variations were included. Methodological quality was generally moderate to good.
    CONCLUSIONS: There is a great degree of variation in the presentation and interpretation of eye contact between and within populations. It remains unclear why specific variations occur in populations. Additionally, no gold standard for how eye contact should be used or interpreted emerged from the studies. Further research into the reason for differences in eye contact between and within populations is recommended.
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  • 文章类型: Systematic Review
    背景:据报道,创伤后应激障碍(PTSD)的患病率和临床表现因性别和/或性别而异。等效复杂PTSD(CPTSD)研究处于起步阶段,迄今为止尚未对此主题进行系统评价。目的:系统地回顾文献并提供叙述,以解决CPTSD患病率和临床表现中是否存在性别和/或性别差异的问题。方法:Embase,PsycINFO,PTSDpubs,PubMed,WebofScience,搜索了EThos和GoogleScholar。12篇论文有资格被列入。数据是通过叙述方式提取和合成的。结果:确定了四个主题:(i)性别和/或性别的报告;(ii)创伤指数;(iii)CPTSD患病率;(iv)CPTSD临床表现。调查结果好坏参半。九篇论文报告了患病率:八篇发现没有性别和/或性别差异;一篇发现女性和/或女性的诊断率更高。四篇论文报告了临床表现:一篇报告了女性和/或女性的聚类水平得分较高;两篇使用单一性别和/或性别样本;一篇发现男性和/或男性的两个聚类得分较高。大多数论文都没有以性别和/或性别敏感的方式进行报道。结论:需要性别和性别敏感性研究和临床实践。建议在研究和临床实践中意识到身份与复杂创伤的经历和表达之间的交叉。
    这篇叙述性综述旨在确定复杂的创伤后应激障碍诊断率和临床表现中是否存在性别和/或性别差异。大多数论文都采用了性别和性别的二元方法。大多数论文报道总体诊断率没有差异,很少有论文报道关于CPTSD演示文稿的混合发现。
    Background: Post-traumatic stress disorder (PTSD) prevalence and clinical presentation reportedly vary with gender and/or sex. Equivalent complex PTSD (CPTSD) research is in its relative infancy and to date no systematic review has been conducted on this topic.Objective: To systematically review the literature and provide a narrative addressing the question of whether gender and/or sex differences exist in CPTSD prevalence and clinical presentation.Method: Embase, PsycINFO, PTSDpubs, PubMed, Web of Science, EThOS and Google Scholar were searched. Twelve papers were eligible for inclusion. Data were extracted and synthesised narratively.Results: Four themes were identified: (i) the reporting of gender and/or sex; (ii) index trauma; (iii) CPTSD prevalence rates; and (iv) CPTSD clinical presentation. Findings were mixed. Nine papers reported prevalence rates: eight found no gender and/or sex differences; one found higher diagnostic rates among women and/or females. Four papers reported clinical presentation: one reported higher cluster-level scores among women and/or females; two used single gender and/or sex samples; and one found higher scores in two clusters in men and/or males. Most papers failed to report in gender- and/or sex-sensitive ways.Conclusions: Gender- and sex-sensitive research and clinical practice is needed. Awareness in research and clinical practice is recommended regarding the intersect between identity and the experience and expression of complex trauma.
    This narrative review aims to establish whether gender and/or sex differences exist in complex post-traumatic stress disorder diagnosis rates and clinical presentation.Most papers adopted a binary approach to sex and gender.Most papers reported no difference in overall diagnosis rates, and few papers reported mixed findings regarding CPTSD presentation.
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  • 文章类型: Case Reports
    在过去的几十年中,皮肤利什曼病的发病率一直在上升。标准治疗通常包括抗利什曼尼药;然而,由于其安全性和毒性阈值低,正在研究替代疗法。COVID-19与皮肤利什曼病之间的关系尚不清楚,探索这种联系可能为感染患者的病理生理学和治疗策略提供重要见解。在这篇文章中,我们描述了一例有心脏病和其他合并症病史的男性患者,在感染COVID-19后,以脓疱疮样皮肤病变的形式出现皮肤利什曼病.由于病人的心脏特征不佳,未使用葡萄糖酸钠,并采用了替代治疗方法。患者口服特比萘芬治疗,对特定病变进行冷冻治疗,和一个疗程的头孢氨苄。在治疗过程和随后的随访之后,患者表现出完全消退和愈合的病灶,并伴有疤痕,未观察到活动性病变或复发。该病例强调了合并症患者皮肤利什曼病的替代治疗策略的潜力,并强调了进一步研究以更好地了解COVID-19与皮肤利什曼病之间联系的重要性。
    Cutaneous leishmaniasis incidence has been rising in the past couple of decades. Standard therapy often includes antileishmanial drugs; however, due to their low safety and toxicity threshold, alternative treatments are being investigated. The association between COVID-19 and cutaneous leishmaniasis remains unclear and exploring this connection may offer crucial insights into the pathophysiology of and treatment strategies for infected patients. In this article, we describe a case of a male patient with a history of cardiac and other comorbidities who presented with cutaneous leishmaniasis in the form of impetigo-like skin lesions after being infected with COVID-19. Due to the patient\'s poor cardiac profile, sodium stibogluconate was not used and an alternative therapeutic approach was employed. The patient was treated with oral terbinafine, cryotherapy on specific lesions, and a course of cephalexin. Following the course of treatment and subsequent follow-up, the patient exhibited complete resolution and healing of the lesions with scarring, and no active lesions or recurrence were observed. This case highlights the potential for alternative treatment strategies for cutaneous leishmaniasis in patients with comorbidities and emphasizes the importance of further research to better understand the link between COVID-19 and cutaneous leishmaniasis.
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  • 文章类型: Journal Article
    背景:乳腺淋巴瘤可分为原发性乳腺淋巴瘤(PBL)或全身性淋巴瘤(SBL)。PBL是一种罕见的疾病,弥漫性大B细胞淋巴瘤(DLBCL)是最常见的亚型。
    目的:在本研究中,在我们的信托中,我们代表了11例诊断为乳腺淋巴瘤的病例;其中2例患有PBL,9例患有SBL.我们主要关注临床表现,诊断,管理和结果。
    方法:我们对2011-2022年期间在我们的信托中诊断出的所有乳腺淋巴瘤患者进行了回顾性研究。患者数据从医院记录系统获得。到目前为止,我们对这些患者进行了随访,以确定每位患者的治疗结果。
    结果:11例患者纳入我们的综述。所有患者均为女性。平均诊断年龄为66.1±13岁。8例患者被诊断为DLBCL,两名患者被诊断为滤泡性淋巴瘤,最后一个是淋巴浆细胞性淋巴瘤。所有患者的标准治疗方案为化疗+/放疗。四名病人在化疗后一年内去世,五名患者达到完全缓解,一名患者有两次复发,仍在治疗中,而最后一名患者最近被诊断出来,仍在等待治疗。
    结论:原发性乳腺淋巴瘤是一种侵袭性疾病。PBL的治疗主要是全身放化疗。手术的作用现在仅限于疾病的诊断。早期诊断和适当治疗对于此类病例的管理至关重要。
    BACKGROUND: Lymphoma of the breast can be classified as either primary breast lymphoma (PBL) or secondary to systemic lymphoma (SBL). PBL is a rare disease with Diffuse Large B cell Lymphomas (DLBCL) being the most common subtype.
    OBJECTIVE: In the current study, we represented eleven cases diagnosed with breast lymphoma in our trust; two of them had PBL and nine had SBL. We focused mainly on the clinical presentation, diagnosis, management and outcomes.
    METHODS: We did this retrospective review for all breast lymphoma patients who were diagnosed in our trust during the periods from 2011-2022. Patients\' data were obtained from the hospital recording system. We followed up these patients thus far to identify the outcome of treatment in each patient.
    RESULTS: Eleven patients were included in our review. All patients were females. Average age of diagnosis was 66.1 ± 13 years of age. Eight patients were diagnosed with DLBCL, two patients were diagnosed with follicular lymphomas, and the last one had lymphoplasmacytic lymphoma. Chemotherapy +∕- radiotherapy was the standard treatment regimen in all patients. Four patients passed away within one year of chemotherapy, five patients achieved complete remission, one patient had two relapses and is still under treatment, while the last patient was diagnosed recently and still awaiting treatment.
    CONCLUSIONS: Primary breast lymphoma is an aggressive disease. The treatment for PBL is mainly systemic with chemoradiotherapy. The role of surgery is now limited to the diagnosis of the disease. Early diagnosis and proper treatment are crucial for the management of such cases.
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  • 文章类型: Case Reports
    重度抑郁症常见于老年人(≥60岁)。称为晚期抑郁症(LLD)。这些患者中多达30%将患有难治性晚期抑郁症(TRLLD),定义为抑郁症持续存在,尽管有两项充分的抗抑郁试验。TRLLD对临床医生来说是个挑战,考虑到几个病因(例如,神经认知状况,医疗合并症,焦虑,和睡眠中断)。正确的评估和管理至关重要,因为患有TRLLD的人经常出现在医疗环境中,并且患有认知能力下降和其他加速衰老的迹象。本文为实践中遇到TRLLD的医生提供循证指南。
    Major depression is common in older adults (≥ 60 years of age), termed late-life depression (LLD). Up to 30% of these patients will have treatment-resistant late-life depression (TRLLD), defined as depression that persists despite two adequate antidepressant trials. TRLLD is challenging for clinicians, given several etiological factors (eg, neurocognitive conditions, medical comorbidities, anxiety, and sleep disruption). Proper assessment and management is critical, as individuals with TRLLD often present in medical settings and suffer from cognitive decline and other marks of accelerated aging. This article serves as an evidence-based guide for medical practitioners who encounter TRLLD in their practice.
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  • 文章类型: Journal Article
    UNASSIGNED:一项针对患有食管闭锁和气管食管瘘(EA±TEF)的新生儿的调查,以确定导致我们机构不良手术结局的其他因素,其中采用改进的护理标准可以改善结局。
    未经评估:我们对54例新生儿进行了回顾性研究,在5年内接受了EA±TEF手术修复。我们收集了病人的人口统计数据,围手术期发现,新生儿重症监护的记录,并确定了性别的影响,胎龄,出生体重,手术年龄,异常类型,共存的主要异常,术前强迫症治疗,术后通气时间对手术效果的影响。
    未经评估:死亡率为51.9%,其中,42.8%的新生儿死于呼吸机相关疾病。手术时的年龄,胎龄,术前Inotrope支持,共存异常的存在,和术后通气时间被确定为预测死亡率的显著变量(P<0.05)。受试者工作曲线下的面积显示术后通气时间是死亡率的最佳指标。上述变量的Logistic回归模型(χ2=11.204,P=0.019)显示,在2.5天之前进行手术的新生儿和需要术后<74.5小时通气的新生儿存活的可能性分别为3.91和48.30倍,比他们的同行。
    UNASSIGNED:由于延迟诊断和/或延迟运输到三级中心和延长通气支持而导致的手术延迟对EA±TEF的手术结局有额外的不利影响。
    UNASSIGNED: A survey of neonates with esophageal atresia and tracheoesophageal fistula (EA ± TEF) to determine additional factors responsible for poor surgical outcomes in our institution where employing an improved standard of care can ameliorate the outcome.
    UNASSIGNED: We carried out a retrospective review of 54 neonates, who underwent surgical repair of EA± TEF over a 5-year period. We collected data regarding the patients\' demographics, perioperative findings, records of neonatal intensive care, and ascertained the effects of gender, gestational age, birth weight, age at operation, type of anomaly, coexisting major anomalies, preoperative inotrope therapy, and duration of postoperative ventilation on the surgical outcome.
    UNASSIGNED: The mortality rate was 51.9%, out of which, 42.8% of neonates succumbed to ventilator-associated conditions. Age at the time of surgery, gestational age, preoperative inotrope support, presence of coexisting anomalies, and duration of postoperative ventilation were determined as the significant variables predicting mortality(P < 0.05). The area under the Receiver Operating Curve showed the duration of postoperative ventilation as the best indicator of mortality. The Logistic regression model (χ2 = 11.204, P = 0.019) with the above-mentioned variables showed that neonates who were operated before 2.5 days and who required <74.5 hours of postoperative ventilation were 3.91 and 48.30 times more likely to survive respectively, than their counterparts.
    UNASSIGNED: A delay in surgery due to delayed diagnosis and or delayed transportation to tertiary centres and prolonged ventilatory support have an additional detrimental effect on the surgical outcomes of EA ± TEF.
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  • 文章类型: Systematic Review
    猴痘是一种人畜共患疾病,中部和西部非洲地区的地方病,并重新出现,目前导致截至2022年5月的疫情爆发。在这次系统审查中,我们的目标是描述疾病的当前面貌,对皮肤粘膜进行了详细的分类,以及该疾病的全身症状。我们搜索了四个主要的在线数据库,关键字为“猴痘”和“正痘病毒”。共收录46篇文章,累计1984年确诊病例。患者主要是与男性发生性关系的男性,他们大多在30多岁,有无保护的性接触或国际旅行史。在皮肤粘膜表现中,肛门生殖器病变是最常见的,然后是四肢的病变,脸,树干,和手掌或鞋底。在病变类型中,膀胱脓疱,脓疱或假脓疱,泡状膜和丘疹性病变是最常见的,主要是异步呈现,每个患者的病变少于10个。几乎所有患者也报告了全身表现,即发烧,淋巴结病,疲劳,肌痛,头痛,咽炎,和直肠炎。性接触是本次疫情的主要传播途径,体液中的病毒脱落起着关键作用。我们已经将这些新爆发的特殊发现与以前的爆发进行了比较。我们还从我们纳入的研究中收集并分类了图像,为这个“新的”猴痘面孔制作了一个“临床地图集”,这对临床医生来说是最重要的,并对猴痘的鉴别诊断有清晰的了解。
    Monkeypox is a zoonotic disease, endemic in central and west African regions, and has re-emerged, currently causing an outbreak as of May 2022. In this systematic review, we aimed to characterize the current face of the disease, with a detailed categorization of mucocutaneous, as well as systemic symptoms of the disease. We searched four main online databases with the keywords \"monkeypox\" and \"Orthopoxvirus\". A total of 46 articles were included, with a cumulative number of 1984 confirmed cases. Patients were predominantly men who have sex with men, who were mostly in their 30s, with a history of unprotected sexual contact or international travel. Among mucocutaneous manifestations, anogenital lesions were the most commonly observed, followed by lesions on the limbs, face, trunk, and palms or soles. Among lesion types, vesiculopustular, pustular or pseudo-pustular, vesicular-umbilicated and papular lesions were the most common, mainly presenting asynchronously, with less than 10 lesions on each patient. Almost all patients also reported systemic manifestations, namely fever, lymphadenopathy, fatigue, myalgia, headaches, pharyngitis, and proctitis. Sexual contact is the main pathway of transmission in the current outbreak, with viral shedding in bodily fluids playing a key role. We\'ve compared these idiosyncratic findings of the new outbreak with previous outbreaks. We\'ve also gathered and categorized images from our included studies to make a \"clinical atlas\" for this \"new\" face of monkeypox, which can be of utmost importance for clinicians to be familiarized with, and have a clear picture of monkeypox for their differential diagnoses.
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  • 文章类型: Case Reports
    简介和重要性尤因肉瘤是一种侵袭性恶性肿瘤,主要影响儿童和年轻人的骨骼系统。
    方法:我们报告了一个14岁男孩的尤文肉瘤的罕见病例,其临床和放射学特征为快速发作的异时性骨转移(诊断后4周内)。
    UNASSIGNED:尽管症状恶化非常迅速,值得注意的是,在存在如此广泛的转移性疾病的情况下,肺本身仍未受累。
    结论:我们描述了一个独特的转移性尤文氏肉瘤病例,该病例表现为全身性疾病进展迅速,并伴有广泛的骨骼转移(和中枢神经系统受累),但没有任何肺部受累的证据。
    Introduction and importance Ewing\'s sarcoma is an aggressive malignancy primarily affecting skeletal system in children and young adults.
    METHODS: We report an unusual case of Ewing sarcoma in a 14-year-old boy with clinical and radiological features of rapid onset metachronous skeletal metastasis (within 4 weeks of diagnosis).
    UNASSIGNED: Although the deterioration of symptoms was very rapid, it is unusual to note that in the presence of such widespread metastatic disease the lungs per se remained uninvolved.
    CONCLUSIONS: We describe a unique case of metastatic Ewing\'s sarcoma who showed rapid systemic disease progression with widespread skeletal metastases (and CNS involvement) but without any evidence of pulmonary involvement.
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  • 文章类型: Review
    人们对开发用于皮下(SC)注射的生物产品的多种演示文稿以进行生命周期管理和产品差异化越来越感兴趣。需要桥接临床研究以将现有数据包外推到新的演示文稿。
    本综述汇编了针对SC途径管理的生物制品进行的桥接临床研究的信息,并在2021年12月31日之前由美国食品和药物管理局的药物评估和研究中心多次批准。有关适应症的信息,演示文稿(S),批准途径,批准时间表,桥接临床研究的各个方面都是从已发表的文件中收集的。
    桥接临床研究的类型可能取决于表现之间的差异程度,现有数据包,和产品开发的阶段。桥接临床研究的设计应基于生物制品的特征,并应旨在检测表现之间的相关差异。正常健康志愿者的单剂量比较药代动力学是最常见的桥接临床研究设计。在这些研究的设计过程中,应考虑体重和注射部位等协变量。还应考虑演示文稿的不同用户界面的影响。
    There is growing interest in the development of multiple presentations for biological products for subcutaneous (SC) injection for life cycle management and product differentiation. Bridging clinical studies are required to extrapolate the existing data package to new presentations.
    This review compiles information of bridging clinical studies conducted for biological products administered by the SC route and approved in more than one presentation by the United States Food and Drug Administration\'s Center for Drug Evaluation and Research up until 31 December 2021. Information regarding indication(s), presentation(s), approval pathways, approval timelines, and various aspects of bridging clinical studies was collected from published documents.
    The type of bridging clinical study can depend on the extent of differences between presentations, existing data packages, and the stage of the product development. Design of a bridging clinical study should be based on the characteristics of a biological product and should be aimed at detecting the relevant differences between presentations. Single-dose comparative pharmacokinetics in normal healthy volunteers is the most common bridging clinical study design. Covariates like body weight and injection site should be considered during the design of these studies. The impact of the different user interfaces of presentations should also be considered.
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  • 文章类型: Review
    背景:原发性甲状腺淋巴瘤(PTL)是一种罕见的恶性肿瘤,约占所有甲状腺恶性肿瘤的5%,不到结外淋巴瘤的2%。弥漫性B细胞淋巴瘤是PTL最常见的病理亚型。
    方法:这是对我院2011年至2021年期间诊断为甲状腺淋巴瘤的所有患者的回顾性回顾。所有患者都有临床,放射学,和病理评估。从诊断到现在,我们一直在跟踪这些患者。
    结果:8例患者纳入我们的综述。四名患者为男性,四名为女性。诊断时的平均年龄为63±32岁。仅通过组织组织学证实诊断。六名患者患有IIE期疾病,两名患有IVE期疾病。4例患者有疾病相关死亡。在其他四名病人中,2人接受了化疗(RCHOP),1人接受了局部放疗;全部完全缓解,最后一例进行了半甲状腺切除术以减轻气道压迫,但仍在治疗中。
    结论:原发性甲状腺淋巴瘤是罕见的甲状腺恶性肿瘤。诊断时的晚期和年龄,压缩表现的存在,大肿瘤块,和远处转移的存在,都是不良预后标准.我们对疾病病理学的了解,诊断,管理仍然有限,需要更多的研究。
    BACKGROUND: Primary thyroid lymphoma (PTL) is a rare malignancy accounting for about 5% of all thyroid malignancies and less than 2% of extra-nodal lymphomas. Diffuse B-cell lymphoma is the most common pathological subtype of PTL.
    METHODS: This is a retrospective review of all patients diagnosed with thyroid lymphoma in our hospital during the period from 2011 to 2021. All patients had clinical, radiological, and pathological evaluation. We have followed up these patients since diagnosis till now.
    RESULTS: Eight patients were included in our review. Four patients were males and four were females. Mean age at diagnosis was 63 ± 32 years of age. Diagnosis was confirmed only with tissue histology. Six patients had stage IIE disease and two had stage IVE disease. Four patients had disease related mortality. Of the other four patients, two had chemotherapy (RCHOP) and one had local radiotherapy; all achieved complete remission, and the last one had hemithyroidectomy to relieve airway compression and still under treatment.
    CONCLUSIONS: Primary thyroid lymphoma is rare malignancy of the thyroid gland. Advanced stage and age at the time of diagnosis, the presence of compression manifestations, large tumor mass, and presence of distant metastasis, all are poor prognostic criteria. Our knowledge of the disease pathology, diagnosis, and management is still limited and more research studies are required.
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