Medicine
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An estimated 1.5 million Kenyans are HIV-seropositive, with 1.1 million on antiretroviral therapy (ART), with the majority of them unaware of their drug resistance status. In this study, we assessed the prevalence of drug resistance to nucleoside reverse transcriptase inhibitors (NRTIs), nucleoside reverse transcriptase inhibitors (NNRTIs), and protease inhibitors, and the variables associated with drug resistance in patients failing treatment in Nairobi, Kenya. This cross-sectional study utilized 128 HIV-positive plasma samples obtained from patients enrolled for routine viral monitoring in Nairobi clinics between 2015 and 2017. ⋯ HIV-1 subtype, age, or ART-regimen were not associated with resistance mutation counts. Drug resistance mutations were found in alarmingly high numbers, and they were associated with viral load and treatment time. This finding emphasizes the importance of targeted resistance monitoring as a tool for addressing the problem.
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The purpose of this study was to investigate the mediating effects of self-acceptance on loneliness and subjective well-being (SWB) among elderly subjects living in Chinese nursing homes. This cross-sectional study was conducted between October 2019 and March 2020. A total of 415 elderly participants aged 60 to 97 years (mean 81.12 ± 8.90 years) from 3 medical and nursing homes in Fuyang city, Anhui province, were selected using a convenience sampling method. ⋯ Low-income people, subjects from rural areas, and those newly admitted to nursing homes should be emphasized in interventions, and appropriate measures should be taken to harmonize the relationships between elderly residents and their children. Self-acceptance partially mediated the relationship between loneliness and SWB. Consequently, self-acceptance should be the focus of improving the SWB of elderly nursing home residents.
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Observational Study
Better discrimination of the concomitant peri-ankle fractures in the spiral tibial shaft fractures by thin-slice axial and three-dimensional CT.
The objective of this study was to examine the morphologic features of spiral tibial shaft as well as concomitant fibular and peri-ankle fractures on multidetector high-resolution CT and to speculate about the mechanisms underlying these combined fractures. This is a retrospective cohort study. A total of 197 tibial shaft fractures underwent multidetector high-resolution CT before intramedullary nailing. ⋯ The displaced syndesmotic injuries commonly coexisting in pronation/external rotation-type ankle injuries were not observed. Most spiral tibial shaft fractures were caused by external rotation force. However, the morphology of concomitant peri-ankle fractures was inconsistent with typical mechanisms of isolated external rotation ankle injuries.
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The coronavirus disease 2019 (COVID-19) pandemic has affected various aspects, including socioeconomic status and health. This retrospective study aimed to investigate the influence of the COVID-19 pandemic on oral health based on the number of teeth that contribute to mastication, and the nutritional status of elderly patients with digestive cancers. The authors defined the before and during COVID-19 periods in this study as January 2019 to December 2019 and January 2020 to December 2020, respectively. ⋯ This study showed that the COVID-19 pandemic during 2020 did not have a significant influence on the oral health and nutritional status of elderly patients with digestive cancer. However, the influence of COVID-19 on community oral health may become apparent in the future. Thus, dental professionals should continue further research regarding the effects of COVID-19 on oral health.
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Observational Study
Vasodilator agents improve hemodialysis vascular access patency: A population-based study from Korea.
Vascular access (VA) failure is an important problem for patients undergoing hemodialysis, and maintaining VA patency is challenging. In this study, we used a nationwide database to investigate the effects of nitrate, as a vasodilator, on VA failure in hemodialysis patients. We investigated the Korean insurance claims data of hemodialysis patients who underwent angioplasty for VA failure between January 2012 and December 2017. ⋯ All vasodilators, except molsidomine, improved the patency rate by approximately 20%. In this large national database study, vasodilator administration was associated with higher VA primary patency, compared with controls, in hemodialysis patients. VDT may have a beneficial effect on maintaining VA patency in patients undergoing hemodialysis.