Abstract Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Background Invasive aspergillosis (IA) is an opportunistic fungal infection in immunocompromised patients with high mortality. Aspergillus flavus is the second pathogen of IA. Breakthrough IA was defined as any IA occurring during exposure to an antifungal drug. Case presentation A 22-year-old female college student was admitted severely unwell with dizziness and left limb weakness. She was healthy previously and did not take any medication. Magnetic resonance imaging showed a right intracranial space-occupying lesion. The postoperative pathological and morphological examinations suggested Aspergillus flavus. The anti-fungal medication, voriconazole, was administered immediately. Unfortunately, her condition deteriorated, and she experienced coma after about 1 month of antifungal treatment. The emergency craniotomy revealed a large amount of pus and the culture of pus confirmed Aspergillus flavus. Antifungal regimen was developed by infectious disease specialists, and drug concentration was monitored continuously. This patient received antifungal treatment for 2 years. No recurrence was observed after 6 months of antifungal drug withdrawal, and she can take care of herself. See Figures below. Conclusion Breakthrough IA occurs in patients who lack high risk factors, making diagnosis more difficult and leading to a higher risk of mortality. Therapeutic drug monitoring is crucial for therapeutic success. Meanwhile, multidisciplinary therapeutics can improve the survival rate.
Aims To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. Methods People with diabetes aged 18–65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. Results A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (P Conclusions Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes.
Bardet–Biedl syndrome (BBS; OMIM 209900) is a rare genetic disease causing damage to multiple organs and affecting patients’ quality of life in late adolescence or early adulthood. In this study, the ocular characteristics including morphology and function, were analyzed in 12 BBS patients from 10 Chinese families by molecular diagnostics. A total of five known and twelve novel variants in four BBS genes ( BBS2 , 58.33%; BBS4 , 8.33%; BBS7 , 16.67%; and BBS9 , 16.67%) were identified in 10 Chinese families with BBS. All patients had typical phenotypes of retinitis pigmentosa with unrecordable or severely damaged cone and rod responses on full-field flash electroretinography (ffERG). Most of the patients showed unremarkable reactions in pattern visual evoked potential (PVEP) and multifocal electroretinography (mfERG), while their flash visual evoked potentials (FVEP) indicated display residual visual function. Changes in the fundus morphology, including color fundus photography and autofluorescence (AF) imaging, were heterogeneous and not consistent with the patients’ functional tests. Overall, our study expands the variation spectrum of the BBS gene, showing that the ocular characteristics of BBS patients are clinically highly heterogeneous, and demonstrates the usefulness of a combination of the ffERG and FVEP assessments of visual function in the advanced stage of retinopathy in BBS.
Objectives.To demonstrate the screening value of echocardiography for portopulmonary hypertension (POPH) in liver transplant candidates. Design. Systematic review and meta-analysisBackground.POPH is a complication of end-stage liver disease that adversely affects the outcome of orthotopic liver transplant.There are no specific symptoms in the early stage of POPH.POPH reduce the survival rate of patients with end-stage liver disease specially if they are not diagnosed.Therefore, early detection may improve prognosis.The objective of this study is to explore the screening value of echocardiography on liver transplant candidates for screening of POPH compared to right heart catheterization (RHC).Method.PubMed, EMBASE and the Cochrane Library were searched by two independent reviewers for potentially eligible studies published up to 30 June 2019 to retrieve data based on per-patient analysis.STATA, Meta-DiSc, and RevMan were applied to perform this meta-analysis. Results.Our search yielded 1576 studies, of which 11 satisfied the inclusion criteria.The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and area under the summary receiver operating characteristic (SROC) curve (AUC) of echocardiography for POPH were 0.85 (95% CI, 0.65-0.94),0.83 (95% CI, 0.73-0.90),4.99 (95% CI, 3.03-8.21),0.19 (95% CI, 0.07-0.46),and 0.91 (95% CI, 0.88-0.93),respectively.Deeks' funnel plot did not indicate the existence of publication bias (P= 0.66).Conclusions.Echocardiography, a noninvasive modality, provides superior screening for POPH, but the diagnosis of POPH still requires RHC.
Acculturation stress, the psychosocial stress associated with changes engendered by the encounter of two divergent cultures, is associated with insomnia independent of chronic stress among Latinas/os. However, the associations of subtypes of acculturation stress (i.e., intrafamilial, extrafamilial), and sleep quality remain understudied. Our aims were to examine the independent associations of intrafamilial stress, extrafamilial stress, and perceived stress with different indicators of sleep quality, and test the moderating effects of depressive symptoms. We hypothesized that intrafamilial and extrafamilial stress would be more strongly associated with poor sleep quality than perceived stress. Using cross-sectional data of healthy Latino adults(N=112) enrolled in the Latino Sleep and Health Study, we conducted separate age and gender adjusted linear regressions to examine the association of intrafamilial stress, extrafamilial stress, and perceived stress with insomnia symptoms and sleep quality. All independent variables were standardized. The moderating effect of depressive symptoms on these associations was tested using cross-products. Perceived stress was measured using Cohen’s Perceived Stress Scale. Intrafamilial and extrafamilial stress scores were calculated by summing the respective response items of Hispanic Stress Inventory. Depressive symptoms were measured using the Beck Depression Inventory. Insomnia symptoms and sleep quality were measured using the Insomnia Severity Index and Pittsburg Sleep Quality Index, respectively. Overall, Mage=41.10 (SD=15.13) and 65.18% were female. One SD increases in intrafamilial and extrafamilial stress were associated with 0.27 and 0.23 increases in insomnia symptoms, respectively (β=0.27;SE=0.12,p=0.02; β=0.23;SE=0.012,p=0.05). Perceived stress was not significantly associated with insomnia (β=0.12;SE=0.12,p=0.33). None of the stress types were significantly associated with sleep quality, but the association of intrafamilial stress with poor sleep quality (β=0.17;SE=0.09,p=0.07) was marginally significant. Depressive symptoms did not moderate these associations. Intrafamilial acculturation stress was most strongly associated with insomnia symptoms, an indicator of sleep quality, while perceived stress was not associated with any indicator of sleep quality. If replicated, our results suggest that behavioral health treatments for insomnia may benefit from additional components that specially address the resolution of strained familial relationships resulting from adapting to U.S. culture. N/A
This paper considers a supply chain system consisting of a manufacturer with her authorized retailers, an unauthorized intermediary and the regional government.Aim at the problem of the manufacturer's price decision and service strategy in two markets under gray market, the demand function influenced by the consumer acceptance of gray goods and the manufacturer and the unauthorized intermediary's profit model are established.By analyzing and discussing the effects of government supervision on manufacturer's pricing decision and service strategy, this paper proposes the manufacturer's optimal price and service strategy.The results show that if the government increases supervision the manufacturer will benefit while products demand and profits of the unauthorized intermediary will decrease.Thus, the government will achieve the target of combating gray market transaction.Besides, the manufacturer's service level when the government does not provide any protection against the gray market is as same as the level when the government provides complete protection.The service level will be higher when the government provides incomplete protection.Furthermore the results are examined by numerical examples.
Objective
To analyze the international current status and hotspots of nursing for cancer symptom cluster and provide references for the cancer nursing in China.
Methods
We searched the Web of Science database and restricted the literature time from the database establishment to 30 May 2016. The retrieval results had been guided into InCites database and bibliographic co-occurrence system, and the implementation of literature metrology and social network analysis were used to analyze the publishing years, core writers, core journals, country/region distributions, etc.
Results
A total of 2 408 papers wrote by 8 171 authors from 62 regions. The amount of papers showed a trend of rising rapidly year by year, especially in recent 10 years. We selected 17 core authors, and most of them came from the University of California. Four core journals were found, including Cancer Nursing, Oncology Nursing Forum, European Journal of Cancer and European Journal of Oncology Nursing. The United States was the most active region and had published 1 282 papers (53.24%). China, included HongKong, Taiwan and China mainland, had published 197 papers (8.18%). The hot spots were following: (1)the symptoms group analysis and symptom management of breast cancer and lung cancer; (2)the study about fatigue-related symptoms, especially the fatigue with pain, sleep disorders or anxiety/depression; (3)the interaction relationship between symptom clusters and quality of life, functional status, emotional status.
Conclusions
Symptom clusters has received world-wide attention. However, correlative research starts late in China, which is in primary stage. Chinese scholars can draw lessons from international advanced technology and theory to promote the development of symptom clusters in China.
Key words:
Bibliometrics; Nursing; Neoplasms; Symptom Cluster
The benefits of breastfeeding are of great significance to not only mothers and infants, but families and the society. Due to the impact of multiple factors, the status of global breastfeeding is not optimistic. This paper elaborated interventions that could promote breastfeeding in different stages and main interaction and support ways, analyzed priorities and problems in current researches, so as to provide basis for the development of reasonable nursing practice.
Key words:
Review; Breastfeeding; Nursing intervention
Madelung disease (MD), a rarely reported disease, also known as benign symmetric lipomatosis, a disorder resulting from alcoholic abuse. It's largely under-recognized and under-reported, possibly because of unawareness of the condition by physicians.A 45-year-old Chinese man presented with intermittent fatigue and abdominal distension and progressive bilateral breast enlargement. He has been a heavy drinker for ten years before onset of the disease with an average daily alcohol intake of more than 120 g/day.Due to the patient's symptoms, laboratory test results, radiographic findings, he was diagnosed with MD.We treated him with abstinence from alcohol and supportive therapy.The patient is now in stable condition, with improvement in symptoms during follow-up.Doctors, confronted with progressive bilateral breast enlargement in a patient with alcoholic liver disease, should be aware of the underreported MD. Recognition of this syndrome could help doctors establish diagnosis and emphasize the importance of alcohol abstinence as the mainstay of management.
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