Despite years of interventions in the United States, substance abuse continues to be a major national problem in our society. For individuals affected, it can constitute a major disability and a decrease in quality of...Despite years of interventions in the United States, substance abuse continues to be a major national problem in our society. For individuals affected, it can constitute a major disability and a decrease in quality of life. Current American societal expectations are that individuals who identify!they are involved in substance abuse will go to treatment, eventually recover, get off public assistance straightaway, and return to work. Most rehabilitation professionals also maintain the same expectations. The reality is that efforts of prevention do not appear to diminish the number of people with substance abuse. Traditional treatment appears to have minimal, if any, influence upon the cessation of substance abuse, and traditional vocational rehabilitation practices appear unsuited for the unique problems and types of symptoms experienced by substance abusers. Creative, yet sound, alternatives that combine effective treatment strategies and non-traditional vocational rehabilitation methods need to be exqlored and tested for effectiveness, and applied.展开更多
Background:Multidrug drug resistant Tuberculosis(MDR-TB)and extensively drug resistant Tuberculosis(XDR-TB)have emerged as significant public health threats worldwide.This systematic review and meta-analysis aimed to ...Background:Multidrug drug resistant Tuberculosis(MDR-TB)and extensively drug resistant Tuberculosis(XDR-TB)have emerged as significant public health threats worldwide.This systematic review and meta-analysis aimed to investigate the effects of community-based treatment to traditional hospitalization in improving treatment success rates among MDR-TB and XDR-TB patients in the 27 MDR-TB High burden countries(HBC).Methods:We searched PubMed,Cochrane,Lancet,Web of Science,International Journal of Tuberculosis and Lung Disease,and Centre for Reviews and Dissemination(CRD)for studies on community-based treatment and traditional hospitalization and MDR-TB and XDR-TB from the 27 MDR-TB HBC.Data on treatment success and failure rates were extracted from retrospective and prospective cohort studies,and a case control study.Sensitivity analysis,subgroup analyses,and meta-regression analysis were used to explore bias and potential sources of heterogeneity.Results:The final sample included 16 studies involving 3344 patients from nine countries;Bangladesh,China,Ethiopia,Kenya,India,South Africa,Philippines,Russia,and Uzbekistan.Based on a random-effects model,we observed a higher treatment success rate in community-based treatment(Point estimate=0.68,95%CI:0.59 to 0.76,p<0.01)compared to traditional hospitalization(Point estimate=0.57,95%CI:0.44 to 0.69,p<0.01).A lower treatment failure rate was observed in community-based treatment 7%(Point estimate=0.07,95%CI:0.03 to 0.10;p<0.01)compared to traditional hospitalization(Point estimate=0.188,95%CI:0.10 to 0.28;p<0.01).In the subgroup analysis,studies without HIV co-infected patients,directly observed therapy short course-plus(DOTS-Plus)implemented throughout therapy,treatment duration>18 months,and regimen with drugs>5 reported higher treatment success rate.In the meta-regression model,age of patients,adverse events,treatment duration,and lost to follow up explains some of the heterogeneity of treatment effects between studies.Conclusion:Community-based management improved treatment outcomes.A mix of interventions with DOTSPlus throughout therapy and treatment duration>18 months as well as strategies in place for lost to follow up and adverse events should be considered in MDR-TB and XDR-TB interventions,as they influenced positively,treatment success.展开更多
目的 评价药物联合康复治疗对高血压性脑出血的疗效。方法 目的选取滕州市工人医院神经内科于2022年4月—2023年4月收治的76例高血压性脑出血患者为研究对象,按照治疗方式不同,分为药物组和康复组,每组28例。药物组接受药物治疗,康复组...目的 评价药物联合康复治疗对高血压性脑出血的疗效。方法 目的选取滕州市工人医院神经内科于2022年4月—2023年4月收治的76例高血压性脑出血患者为研究对象,按照治疗方式不同,分为药物组和康复组,每组28例。药物组接受药物治疗,康复组接受药物联合康复治疗,比较两组的神经系统功能评分和日常生活能力评分,以及并发症的发生率的差异。结果 康复组治疗后的美国国立卫生研究院卒中量表评分(National Institute of Health Stroke Scale,NIHSS)小于药物组,差异有统计学意义(P<0.05);日常生活能力量表(Activity of Daily Living Scale,ADL)评分大于药物组,差异有统计学意义(P<0.05);康复组无并发症发生,药物组的并发症发生率为15.79%(6/38),差异有统计学意义(χ^(2)=4.607,P=0.031)。结论 药物联合康复治疗下的高血压性脑出血患者,神经功能得到改善,日常生活能力较好,并且发生并发症的概率较小。药物联合康复治疗对于高血压性脑出血的患者较适用。展开更多
当我们临床医师似乎已经学会了应用各种最新权威指南一致推荐的有理有据的食品药品监督管理局（Food and Drug Administration,FDA）批准的阿尔茨海默病（Alzheimer’s disease,AD）一线治疗药物乙酰胆碱酯酶抑制剂（acetylcholinestera...当我们临床医师似乎已经学会了应用各种最新权威指南一致推荐的有理有据的食品药品监督管理局（Food and Drug Administration,FDA）批准的阿尔茨海默病（Alzheimer’s disease,AD）一线治疗药物乙酰胆碱酯酶抑制剂（acetylcholinesterase inhibitors,ACh EI）及谷氨酸NMDA受体（N-methyl-D-aspartic acid receptor）拮抗剂治疗痴呆时,展开更多
文摘Despite years of interventions in the United States, substance abuse continues to be a major national problem in our society. For individuals affected, it can constitute a major disability and a decrease in quality of life. Current American societal expectations are that individuals who identify!they are involved in substance abuse will go to treatment, eventually recover, get off public assistance straightaway, and return to work. Most rehabilitation professionals also maintain the same expectations. The reality is that efforts of prevention do not appear to diminish the number of people with substance abuse. Traditional treatment appears to have minimal, if any, influence upon the cessation of substance abuse, and traditional vocational rehabilitation practices appear unsuited for the unique problems and types of symptoms experienced by substance abusers. Creative, yet sound, alternatives that combine effective treatment strategies and non-traditional vocational rehabilitation methods need to be exqlored and tested for effectiveness, and applied.
文摘Background:Multidrug drug resistant Tuberculosis(MDR-TB)and extensively drug resistant Tuberculosis(XDR-TB)have emerged as significant public health threats worldwide.This systematic review and meta-analysis aimed to investigate the effects of community-based treatment to traditional hospitalization in improving treatment success rates among MDR-TB and XDR-TB patients in the 27 MDR-TB High burden countries(HBC).Methods:We searched PubMed,Cochrane,Lancet,Web of Science,International Journal of Tuberculosis and Lung Disease,and Centre for Reviews and Dissemination(CRD)for studies on community-based treatment and traditional hospitalization and MDR-TB and XDR-TB from the 27 MDR-TB HBC.Data on treatment success and failure rates were extracted from retrospective and prospective cohort studies,and a case control study.Sensitivity analysis,subgroup analyses,and meta-regression analysis were used to explore bias and potential sources of heterogeneity.Results:The final sample included 16 studies involving 3344 patients from nine countries;Bangladesh,China,Ethiopia,Kenya,India,South Africa,Philippines,Russia,and Uzbekistan.Based on a random-effects model,we observed a higher treatment success rate in community-based treatment(Point estimate=0.68,95%CI:0.59 to 0.76,p<0.01)compared to traditional hospitalization(Point estimate=0.57,95%CI:0.44 to 0.69,p<0.01).A lower treatment failure rate was observed in community-based treatment 7%(Point estimate=0.07,95%CI:0.03 to 0.10;p<0.01)compared to traditional hospitalization(Point estimate=0.188,95%CI:0.10 to 0.28;p<0.01).In the subgroup analysis,studies without HIV co-infected patients,directly observed therapy short course-plus(DOTS-Plus)implemented throughout therapy,treatment duration>18 months,and regimen with drugs>5 reported higher treatment success rate.In the meta-regression model,age of patients,adverse events,treatment duration,and lost to follow up explains some of the heterogeneity of treatment effects between studies.Conclusion:Community-based management improved treatment outcomes.A mix of interventions with DOTSPlus throughout therapy and treatment duration>18 months as well as strategies in place for lost to follow up and adverse events should be considered in MDR-TB and XDR-TB interventions,as they influenced positively,treatment success.
文摘目的 评价药物联合康复治疗对高血压性脑出血的疗效。方法 目的选取滕州市工人医院神经内科于2022年4月—2023年4月收治的76例高血压性脑出血患者为研究对象,按照治疗方式不同,分为药物组和康复组,每组28例。药物组接受药物治疗,康复组接受药物联合康复治疗,比较两组的神经系统功能评分和日常生活能力评分,以及并发症的发生率的差异。结果 康复组治疗后的美国国立卫生研究院卒中量表评分(National Institute of Health Stroke Scale,NIHSS)小于药物组,差异有统计学意义(P<0.05);日常生活能力量表(Activity of Daily Living Scale,ADL)评分大于药物组,差异有统计学意义(P<0.05);康复组无并发症发生,药物组的并发症发生率为15.79%(6/38),差异有统计学意义(χ^(2)=4.607,P=0.031)。结论 药物联合康复治疗下的高血压性脑出血患者,神经功能得到改善,日常生活能力较好,并且发生并发症的概率较小。药物联合康复治疗对于高血压性脑出血的患者较适用。
文摘当我们临床医师似乎已经学会了应用各种最新权威指南一致推荐的有理有据的食品药品监督管理局（Food and Drug Administration,FDA）批准的阿尔茨海默病（Alzheimer’s disease,AD）一线治疗药物乙酰胆碱酯酶抑制剂（acetylcholinesterase inhibitors,ACh EI）及谷氨酸NMDA受体（N-methyl-D-aspartic acid receptor）拮抗剂治疗痴呆时,
