To determine the frequency of subjective sleep problems in spinocerebellar ataxia type 6 (SCA6), the authors surveyed 25 patients and 25 age-matched controls with the Epworth Sleepiness Scale (ESS) and Pittsburgh Seep...To determine the frequency of subjective sleep problems in spinocerebellar ataxia type 6 (SCA6), the authors surveyed 25 patients and 25 age-matched controls with the Epworth Sleepiness Scale (ESS) and Pittsburgh Seep Quality Index (PSQI). The ESS was higher in patients with SCA6 (9.12 ±5.80; CI: 2.28) than in controls (4.96 ±3.01; CI: 1.18) (p = 0.003, t test). The PSQI was higher in patients with SCA6 (7.96 ±4.65; CI: 1.86) than in controls (5.08 ±3.39; CI: 1.36)-(p = 0.018, t test).展开更多
Objective. To date, very few studies have been conducted on the neurodevelopmental well-being of children conceived through intracytoplasmic sperm injection (ICSI). The limitations of these studies often include a lac...Objective. To date, very few studies have been conducted on the neurodevelopmental well-being of children conceived through intracytoplasmic sperm injection (ICSI). The limitations of these studies often include a lack of comparison with a demographically matched, naturally conceived (NC) group and the investigation of only very young children, with relatively small samples sizes. One study showed that there were no differences in IQ scores among ICSI-conceived, in vitro fertilization (IVF)-conceived, and NC children at 5 years of age. Unfortunately, psychomotor development was not assessed in that study. Because findings regarding these children’s cognitive and motor development are inconclusive, the aim of this study was to shed more light on the cognitive and motor development of 5-year-old ICSI-conceived children. Methods. A total of 511 ICSI-conceived children were compared with 424 IVF-conceived children and 488 NC controls. Children were recruited in 5 European countries, ie, Belgium, Denmark, Greece, Sweden, and the United Kingdom. Participation rates ranged from 45%to 96%in the ICSI and IVF groups and from 34%to 78%in the NC group. Cognitive and motor development was assessed with the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) and McCarthy Scales of Children’s Abilities (MSCA) Motor Scale, respectively. The WPPSI-R consists of 2 major scales, ie, Verbal and Performance, each including 6 subtests. The 6 Performance Scale subtests are object assembly, geometric design, block design, mazes, picture completion, and animal pegs. The 6 Verbal Scale subtests are information, comprehension, arithmetic, vocabulary, similarities, and sentences. Scores on the Performance and Verbal Scale subtests are summed to yield the performance IQ (PIQ) and verbal IQ (VIQ), respectively. Scores on both the Performance Scale and the Verbal Scale yield the full scale IQ (FSIQ). IQ scales have a mean score of 100 and a SD of 15. Each subtest has a mean score of 10 and a SD of 3. The MSCA consists of 6 scales, ie, Verbal, Perceptual-Performance, Quantitative, General Cognitive, Memory, and Motor Scale. In this study, only the Motor Scale was administered. This scale assesses the child’s coordination during performance of a variety of gross-and fine-motor tasks. Leg coordination, arm coordination, and imitative action tests provide measures of gross-motor ability. Draw-a-design and draw-a-child assess fine-motor coordination, as revealed by the levels of hand coordination and finger dexterity. The mean score for this test is 50, with a SD of 10. Results. No differences were identified among ICSI, IVF, and NC children with respect to VIQ, PIQ, or FSIQ scores of the WPPSI-R. Furthermore, there were no differences between groups regarding the discrepancy between VIQ and PIQ scores. These results were not influenced by gender, country, or maternal educational level. However, in the subgroup of first born children with mothers who gave birth at an older age (33-45 years), NC children obtained significantly better VIQ and FSIQ scores than did children conceived through assisted reproductive technologies. These differences in VIQ and FSIQ scores between ICSI/IVF and NC children were relative, because NC children scored < 1 IQ point higher than ICSI/IVF children. Therefore, these scores show no clinical relevance. For Verbal Scale subtests, variables such as age of the mother at the time of the birth, educational level of them other, and gender and nationality of the child interacted with mode of conception, resulting in clinically irrelevant differences between scores for the ICSI/IVF and NC groups on the arithmetic, vocabulary, and comprehension subtests. For Performance Scale subtests, these same demographic factors interacted with mode of conception for the block design, object assembly, and animal pegs subtests, again resulting in clinically irrelevant differences among groups. In the 3 groups (ICSI, IVF, and NC), we observed equal numbers of children scoring below 1 SD from the mean on the WPPSI-R and the MSCA. Conclusions. This study includes a substantial number of children from several European countries. Apart from a few interaction effects between mode of conception and demographic variables, no differences were found when ICSI, IVF, and NC scores on the WPPSI-R and MSCA Motor Scale were compared. Nevertheless, the aforementioned interaction effects could indicate that demographic variables such as maternal age at the time of the birth and maternal educational level play different roles in the cognitive development of IVF and ICSI children, compared with NC children. Additional research is needed to explore and verify this finding. Previous studies revealed that ICSI children, in comparison with NC children, more frequently obtained scores below 1 SD from the mean on 3 subtests of the Performance Scale (object assembly, block design, and mazes) or showed a trend of 5.2%of ICSI children, compared with 2.5%of IVF children and 0.9%of NC children, obtaining a score below 1 SD from the mean, but those findings were not confirmed in this study. Here no differences were found among the 3 groups in the numbers of children scoring below 1 SD from the mean on the VIQ, PIQ, and FSIQ tests and the Verbal and Performance Scale subtests. Motor development results were somewhat more conclusive. There were no differences between the scores of ICSI, IVF, and NC children on the MCSA Motor Scale. No interaction effects were found between mode of conception and demographic variables, indicating that these results are not influenced by gender, nationality, maternal educational level, or maternal age at the time of the birth. Furthermore, equal proportions of children in all 3 groups scored below 1 SD from the mean. The results of this study are reassuring for parents who conceived through ICSI (or IVF). The findings indicate that the motor and cognitive development of their offspring is very similar to that of NC children. However, demographic factors such as maternal educational level and maternal age at the time of the birth might play different roles in the cognitive development of ICSI and IVF children, compared with NC children.展开更多
目的:探讨医护合作—快速康复模式在经输尿管镜钬激光碎石手术中的临床应用及效果。方法:选择2020年2—11月在深圳市中西医结合医院行经输尿管镜钬激光碎石手术的240例患者作为研究对象,用数字双盲法分为对照组和研究组,每组各120例,对...目的:探讨医护合作—快速康复模式在经输尿管镜钬激光碎石手术中的临床应用及效果。方法:选择2020年2—11月在深圳市中西医结合医院行经输尿管镜钬激光碎石手术的240例患者作为研究对象,用数字双盲法分为对照组和研究组,每组各120例,对照组行常规护理,研究组在常规护理的基础上联合医护合作—快速康复模式干预。对比两组患者手术指标、应激反应情况、数字评估分量表(NRS)、日常生活能力调查量表(ADL)评分。结果:研究组手术中出血量低于对照组,差异有统计学意义(t=16.893,P<0.05),手术后各指标恢复时间短于对照组,差异有统计学意义(t=13.903、8.056、11.900、11.610,P<0.05);手术前NRS、ADL评分比较,差异无统计学意义(t=0.109、0.009,P>0.05),术后3 d研究组NRS评分低于对照组、护理后第14 d ADL评分高于对照组,差异有统计学意义(t=23.646、21.153,P<0.05)。结论:将医护合作—快速康复模式应用于经输尿管镜钬激光碎石手术患者围术期内,可有效缩短患者康复时间,减轻应激反应及术后疼痛,提高其日常生活能力,具有推广价值。展开更多
文摘To determine the frequency of subjective sleep problems in spinocerebellar ataxia type 6 (SCA6), the authors surveyed 25 patients and 25 age-matched controls with the Epworth Sleepiness Scale (ESS) and Pittsburgh Seep Quality Index (PSQI). The ESS was higher in patients with SCA6 (9.12 ±5.80; CI: 2.28) than in controls (4.96 ±3.01; CI: 1.18) (p = 0.003, t test). The PSQI was higher in patients with SCA6 (7.96 ±4.65; CI: 1.86) than in controls (5.08 ±3.39; CI: 1.36)-(p = 0.018, t test).
文摘Objective. To date, very few studies have been conducted on the neurodevelopmental well-being of children conceived through intracytoplasmic sperm injection (ICSI). The limitations of these studies often include a lack of comparison with a demographically matched, naturally conceived (NC) group and the investigation of only very young children, with relatively small samples sizes. One study showed that there were no differences in IQ scores among ICSI-conceived, in vitro fertilization (IVF)-conceived, and NC children at 5 years of age. Unfortunately, psychomotor development was not assessed in that study. Because findings regarding these children’s cognitive and motor development are inconclusive, the aim of this study was to shed more light on the cognitive and motor development of 5-year-old ICSI-conceived children. Methods. A total of 511 ICSI-conceived children were compared with 424 IVF-conceived children and 488 NC controls. Children were recruited in 5 European countries, ie, Belgium, Denmark, Greece, Sweden, and the United Kingdom. Participation rates ranged from 45%to 96%in the ICSI and IVF groups and from 34%to 78%in the NC group. Cognitive and motor development was assessed with the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) and McCarthy Scales of Children’s Abilities (MSCA) Motor Scale, respectively. The WPPSI-R consists of 2 major scales, ie, Verbal and Performance, each including 6 subtests. The 6 Performance Scale subtests are object assembly, geometric design, block design, mazes, picture completion, and animal pegs. The 6 Verbal Scale subtests are information, comprehension, arithmetic, vocabulary, similarities, and sentences. Scores on the Performance and Verbal Scale subtests are summed to yield the performance IQ (PIQ) and verbal IQ (VIQ), respectively. Scores on both the Performance Scale and the Verbal Scale yield the full scale IQ (FSIQ). IQ scales have a mean score of 100 and a SD of 15. Each subtest has a mean score of 10 and a SD of 3. The MSCA consists of 6 scales, ie, Verbal, Perceptual-Performance, Quantitative, General Cognitive, Memory, and Motor Scale. In this study, only the Motor Scale was administered. This scale assesses the child’s coordination during performance of a variety of gross-and fine-motor tasks. Leg coordination, arm coordination, and imitative action tests provide measures of gross-motor ability. Draw-a-design and draw-a-child assess fine-motor coordination, as revealed by the levels of hand coordination and finger dexterity. The mean score for this test is 50, with a SD of 10. Results. No differences were identified among ICSI, IVF, and NC children with respect to VIQ, PIQ, or FSIQ scores of the WPPSI-R. Furthermore, there were no differences between groups regarding the discrepancy between VIQ and PIQ scores. These results were not influenced by gender, country, or maternal educational level. However, in the subgroup of first born children with mothers who gave birth at an older age (33-45 years), NC children obtained significantly better VIQ and FSIQ scores than did children conceived through assisted reproductive technologies. These differences in VIQ and FSIQ scores between ICSI/IVF and NC children were relative, because NC children scored < 1 IQ point higher than ICSI/IVF children. Therefore, these scores show no clinical relevance. For Verbal Scale subtests, variables such as age of the mother at the time of the birth, educational level of them other, and gender and nationality of the child interacted with mode of conception, resulting in clinically irrelevant differences between scores for the ICSI/IVF and NC groups on the arithmetic, vocabulary, and comprehension subtests. For Performance Scale subtests, these same demographic factors interacted with mode of conception for the block design, object assembly, and animal pegs subtests, again resulting in clinically irrelevant differences among groups. In the 3 groups (ICSI, IVF, and NC), we observed equal numbers of children scoring below 1 SD from the mean on the WPPSI-R and the MSCA. Conclusions. This study includes a substantial number of children from several European countries. Apart from a few interaction effects between mode of conception and demographic variables, no differences were found when ICSI, IVF, and NC scores on the WPPSI-R and MSCA Motor Scale were compared. Nevertheless, the aforementioned interaction effects could indicate that demographic variables such as maternal age at the time of the birth and maternal educational level play different roles in the cognitive development of IVF and ICSI children, compared with NC children. Additional research is needed to explore and verify this finding. Previous studies revealed that ICSI children, in comparison with NC children, more frequently obtained scores below 1 SD from the mean on 3 subtests of the Performance Scale (object assembly, block design, and mazes) or showed a trend of 5.2%of ICSI children, compared with 2.5%of IVF children and 0.9%of NC children, obtaining a score below 1 SD from the mean, but those findings were not confirmed in this study. Here no differences were found among the 3 groups in the numbers of children scoring below 1 SD from the mean on the VIQ, PIQ, and FSIQ tests and the Verbal and Performance Scale subtests. Motor development results were somewhat more conclusive. There were no differences between the scores of ICSI, IVF, and NC children on the MCSA Motor Scale. No interaction effects were found between mode of conception and demographic variables, indicating that these results are not influenced by gender, nationality, maternal educational level, or maternal age at the time of the birth. Furthermore, equal proportions of children in all 3 groups scored below 1 SD from the mean. The results of this study are reassuring for parents who conceived through ICSI (or IVF). The findings indicate that the motor and cognitive development of their offspring is very similar to that of NC children. However, demographic factors such as maternal educational level and maternal age at the time of the birth might play different roles in the cognitive development of ICSI and IVF children, compared with NC children.
文摘目的探索蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)和国际人类免疫缺陷病毒痴呆量表(international human immunodeficiency virus dementia scale,IHDS)筛查人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染男男同性性行为者(men who have sex with men,MSM)无症状认知功能损伤(asymptomatic neurocognitive impairment,ANI)和人类免疫缺陷病毒相关性痴呆(human immunodeficiency virus-associated dementia,HAD)的效能。方法根据排除标准纳入2016年12月至2018年12月在沈阳中国医科大学附属第一医院就诊的HIV感染MSM 210例和自愿咨询检测的HIV阴性MSM 84例。分别采用MoCA和IHDS对HIV感染MSM和HIV阴性MSM进行横断面认知功能评估,分析各量表在ANI和HAD中的筛查效能。统计学分析采用t检验、单因素方差分析、χ2检验。结果HIV阳性MSM的MoCA和IHDS总分[(26.04±3.41)分和(11.15±1.44)分]均低于HIV阴性MSM[(27.58±1.85)分和(11.67±0.52)分],差异均有统计学意义(t=-4.970、-4.542,均P<0.01)。不同认知功能的HIV感染者MoCA、IHDS总分差异均有统计学意义(F=117.982、49.291,均P<0.05),MoCA<26分、IHDS≤10分所占比例差异均有统计学意义(χ2=115.917、70.155,均P<0.05)。ANI筛查中,MoCA以<26分为阈值,灵敏度为79%,特异度为91%,约登指数为0.70;IHDS以≤11分为阈值,灵敏度为74%,特异度为75%,约登指数为0.49。HAD筛查中,MoCA以<24分为阈值,灵敏度为88%,特异度为87%,约登指数为0.75;IHDS以≤10分为阈值,灵敏度为68%,特异度为87%,约登指数为0.55。结论MoCA比IHDS更适用于HIV感染MSM认知功能障碍的筛查,对于不同程度认知功能障碍应采用不同分数阈值。
文摘目的:探讨医护合作—快速康复模式在经输尿管镜钬激光碎石手术中的临床应用及效果。方法:选择2020年2—11月在深圳市中西医结合医院行经输尿管镜钬激光碎石手术的240例患者作为研究对象,用数字双盲法分为对照组和研究组,每组各120例,对照组行常规护理,研究组在常规护理的基础上联合医护合作—快速康复模式干预。对比两组患者手术指标、应激反应情况、数字评估分量表(NRS)、日常生活能力调查量表(ADL)评分。结果:研究组手术中出血量低于对照组,差异有统计学意义(t=16.893,P<0.05),手术后各指标恢复时间短于对照组,差异有统计学意义(t=13.903、8.056、11.900、11.610,P<0.05);手术前NRS、ADL评分比较,差异无统计学意义(t=0.109、0.009,P>0.05),术后3 d研究组NRS评分低于对照组、护理后第14 d ADL评分高于对照组,差异有统计学意义(t=23.646、21.153,P<0.05)。结论:将医护合作—快速康复模式应用于经输尿管镜钬激光碎石手术患者围术期内,可有效缩短患者康复时间,减轻应激反应及术后疼痛,提高其日常生活能力,具有推广价值。
