Transition from first illegal drug use to first injection among people who inject drugs in Northern Mexico: A retrospective survival analysis / Transición del primer consumo de drogas ilegales a la primera inyección entre las personas que se inyectan drogas en el norte de México: un análisis retrospectivo de supervivencia

Abstract Introduction There is little information in Mexico about the transition to injecting drugs among drug users in cities other than Tijuana. Objective We compare characteristics of the onset of drug use and first injection among people who inject drugs (PWID) from Ciudad Juárez and Hermosillo, two cities of Northern Mexico and identify factors associated with faster rates of transition from first drug use to the first injection. Method 841 PWID were interviewed in 2012 in Ciudad Juárez (n = 445) and Hermosillo (n = 396). Using lifetables, we describe timing at the onset of drug use and first injection. Cox regression analysis was used to determine factors associated with the transition hazard to first injection. Results Median age at onset of drug use was 15.5 years old (standard deviation [SD] = 5.73). The median age at first injection was 21.30 (SD = 7.22). The median duration-time between first drug use and transition to injection was 4.8 years (SD = 5.6). Controlling for sociodemographics, factors that increase the hazard of transitioning to injection are age at onset of drug use (adjusted-hazard-rate [AHR] = 1.04, 95% confidence-interval CI [1.03, 1.05], p<.01) having used cocaine, heroin, or methamphetamine at the onset of drug use (AHR = 1.14, 95% CI [1.03, 1.27], p = .01), and having received assistance at first injection (AHR = 1.25, 95% CI [1.17, 1.33], p<.01). Discussion and conclusion Results show the need to enhance harm reduction programs among non-injecting drug users so as to prevent the spread of injecting drugs in Mexico.

Resumen Introducción Existe poca información en México sobre los calendarios al uso inyectado de drogas en ciudades distintas a Tijuana. Objetivo Comparamos las características del inicio del consumo de drogas y la primera inyección entre las personas que se inyectan drogas (PID) de Hermosillo y Ciudad Juárez e identificamos factores asociados con la transición a la primera inyección. Método En 2012 encuestamos a 841 PID en Ciudad Juárez (n = 445) y Hermosillo (n = 396). Utilizando tablas de vida analizamos las edades al primer uso de sustancias ilícitas y de la primera inyección. Ajustamos un modelo de regresión Cox para determinar los factores asociados con el riesgo de transición a la primera inyección. Resultados La edad mediana al primer consumo de drogas fue 15.5 años (desviación estándar [DE] = 5.73). La edad mediana a la primera inyección fue 21.30 (DE = 7.22). La duración mediana entre el primer uso de drogas ilícitas y la primera inyección fue de 4.8 años (DE = 5.6). Controlando los factores sociodemográficos, los factores que aumentan el riesgo de transición a la inyección son la edad al inicio de uso de drogas ([AHR] = 1.04, intervalo de confianza [IC] del 95% [1.03, 1.05], p<.01) uso de cocaína, heroína o metanfetamina como droga de inicio (AHR = 1.14, IC 95% [1.03, 1.27], p = .01) y haber recibido asistencia en la primera inyección (AHR = 1.25, IC 95% [1.17, 1.33], p<.01). Discusión y conclusión Es necesario mejorar los programas de reducción de daños entre los consumidores de drogas no inyectables para prevenir la propagación del uso inyectado de sustancias en el norte de México.

Factors associated with smoking and transitioning to nyaope injection amongst women in the City of Tshwane Municipality: A self-report by women

Background: Substance use disorder has emerged as a key health and social challenge in South Africa (SA). It is projected that about 15% of South African youth, especially young women are prone to engage in drug use and the prospects of coming into contact with nyaope, a highly addictive drug, are higher. Nyaope is mainly smoked, but the prevalence of injecting it is increasing in most regions. Aim: This study aimed to explore and describe the perception of women, who use nyaope, about the factors contributing to nyaope smoking and transitioning to injecting nyaope amongst women in the City of Tshwane Municipality (CoT), Gauteng. Setting: The research was conducted within Community Oriented Substance Use Programme sites across the CoT Municipality. Methods: Qualitative research methods were utilised to explore and describe the perceptions of the participants on factors contributing to the use of nyaope amongst women residing in the CoT. Data were collected through face-to-face interviews and thematically analysed. Results: Intimate partner influence (IPI), peer pressure, being misled by friends, weight loss, lack of effective coping mechanisms and counteracting other drugs contributed to women smoking nyaope. Additionally, a need for an intense high, IPI, influence by the social network, curiosity and cost-effectiveness contributed to women transitioning from smoking to injecting nyaope. Conclusion: The study has established factors contributing to smoking and transition to injecting nyaope as viewed by women residing in the CoT.

A Brazilian cost-utility analysis of trabecular micro-bypass with iStent inject® for the treatment of open-angle glaucoma / Análise de custo-utilidade do implante trabecular iStent inject® para o tratamento do glaucoma de ângulo aberto no Brasil

ABSTRACT Purpose To evaluate the cost-utility of the iStent inject® for the treatment of mild-to-moderate open-angle glaucoma (OAG) within the Brazilian Unified Health System (SUS). Methods A Markov model was developed, in which the effectiveness outcome measure was the incremental cost-effectiveness ratio (ICER: R$ / QALY quality-adjusted life-year). Direct medical costs were obtained from the SUS perspective. The base case comprised of a hypothetical cohort of patients with OAG using topical medication and being managed according to the Clinical Protocol and Therapeutic Guidelines (PCDT) and a real-world setting based on data from Datasus. The model's robustness through sensitivity analyses was tested. Results In the PCDT base case setting, the trabecular micro-bypass implant provided gains of 0.47 QALYs and an ICER of R$7,996.66/QALY compared to treatment with topical medication. In the real-world setting based on data from Datasus, the trabecular micro-bypass implant, provided gains of 0.47 QALYs and an ICER of R$4,485.68/QALY compared to treatment with topical medication. The results were robust to sensitivity analyses. Conclusion Incorporating iStent inject® to SUS provides an improvement in the patient's quality of life with an additional cost that warrants the benefit provided to patients. Results may be considered cost-effective compared to topical medication.

RESUMO Objetivo Avaliar a relação custo-utilidade do iStent inject® para o tratamento do glaucoma de ângulo aberto leve a moderado no Sistema Único de Saúde. Métodos Foi desenvolvido um modelo de Markov, no qual a medida de resultado de efetividade foi a razão custo-efetividade incremental (razão de custo-efetividade incremental: R$/ano de vida ajustado pela qualidade). Os custos médicos diretos foram obtidos por meio da perspectiva do Sistema Único de Saúde. O caso base foi composto de uma coorte hipotética de pacientes com glaucoma de ângulo aberto em uso de medicação tópica tratados de acordo com o Protocolo Clínico e Diretrizes Terapêuticas e um cenário do mundo real baseado em dados do Departamento de Informática do Sistema Único de Saúde. Foi testada a robustez do modelo por meio de análises de sensibilidade. Resultados No cenário base do Protocolo Clínico e Diretrizes Terapêuticas, o implante trabecular micro-bypass proporcionou ganhos de 0,47 ano de vida ajustado pela qualidade e razão de custo-efetividade incremental de R$7.996,66/ano de vida ajustado pela qualidade em relação ao tratamento com medicação tópica. No cenário real baseado em dados do Departamento de Informática do Sistema Único de Saúde, o implante trabecular proporcionou ganhos de 0,47 ano de vida ajustado pela qualidade e razão de custo-efetividade incremental de R$ 4.485,68/ano de vida ajustado pela qualidade em relação ao tratamento com medicação tópica. Os resultados foram robustos para análises de sensibilidade. Conclusão A incorporação do iStent inject® ao Sistema Único de Saúde proporciona melhora na qualidade de vida do paciente com um custo adicional que garante o benefício proporcionado a eles. Os resultados podem ser considerados custo-efetivos em comparação com a medicação tópica.

Point-of-care hepatitis C screening with direct access referral to improve linkage to care among halfway house residents: a pilot randomised study

INTRODUCTION@#Linkage to care among individuals with substance misuse remains a barrier to the elimination of the hepatitis C virus (HCV). We aimed to determine whether point-of-care (PoC) education, screening and staging for liver disease with direct access to hospitals would improve linkage to care among this group. @*METHODS@#All participants were offered PoC education and HCV screening. HCV-positive participants were randomised to standard care (controls) or direct access, which provided a direct pathway to hospitals. Linkage to care was determined by reviewing electronic medical records. Linkage of care cascade was defined as attendance at the specialist clinic, confirmation of viraemia by HCV RNA testing, discussion about HCV treatment and initiation of treatment. @*RESULTS@#351 halfway house residents were screened. The overall HCV prevalence was 30.5% (n = 107), with 69 residents in the control group and 38 in the direct access group. The direct access group had a significantly higher percentage of cases linked to specialist review for confirmatory RNA testing (63.2% vs. 40.6%, p = 0.025), HCV treatment discussion (p = 0.009) and treatment initiation (p = 0.01) compared to the controls. Overall, only 12.6% (n = 13) had treatment initiation during follow-up. PoC HCV screening with direct access referral had significantly higher linkage to HCV treatment initiation (adjusted odds ratio 9.13, p = 0.005) in multivariate analysis. @*CONCLUSION@#PoC HCV screening with direct access improves linkage to care and simplifies the HCV care cascade, leading to improved treatment uptake. PoC education, screening, diagnosis and treatment may be an effective strategy to achieving HCV micro-elimination in this population.

Impact of funding harm reduction programs for people who inject drugs in Mexico / Impacto del financiamiento de programas de reducción del daño para personas que se inyectan drogas en México

Abstract Introduction Despite evidence from harm reduction programs, there are limited data on their impact in Mexico. The Mexican National HIV Program has supported harm reduction programs implemented by community-based organizations both financially and technically. Objective To obtain an estimate of HIV infections averted from 2015 to 2018. Method A deterministic model was developed to estimate the number of infections, with harm reduction projects financed by CENSIDA and implemented by Community-Based Organizations, using data reported from the period 2015 to 2018. The benefit was obtained by estimating the costs of providing prevention programs and comparing the latter to the costs of providing care. Results An analysis of 66,973 people included in harm reduction programs showed that an estimated 869 HIV infections were averted between 2015 and 2018. Potential savings obtained by providing these harm reduction services exceeded over $600,000 Mexican pesos for every infection averted. Discussion and conclusion Harm reduction services play a key role in reducing the incidence of HIV in Mexico. Ensuring their financing is necessary since, combined with other services, they are a cost-effective tool for reducing the economic and public health burden of HIV/AIDS.

Resumen Introducción A pesar de la evidencia que aportan los programas de reducción de daños, hay pocos datos sobre el impacto que tienen en México. El Programa Nacional de VIH en México ha apoyado técnica y financieramente la implementación de proyectos de reducción de daños operados por la sociedad civil. Objetivo Estimar el número de infecciones de VIH evitadas en el periodo de 2015 a 2018. Método Se desarrolló un modelo determinista para estimar el número de infecciones evitadas con los proyectos de reducción de daños financiados por CENSIDA e implementados por organizaciones de la sociedad civil a partir de los datos reportados durante el periodo 2015-2018. El beneficio se obtuvo al estimar el costo de proveer programas de prevención comparado con el costo de proveer tratamiento. Resultados Del análisis de 66,973 personas contactadas con los programas, se estimaron 869 infecciones de VIH evitadas entre 2015 y 2018. El ahorro potencial de proveer estos servicios de reducción de daños fue de más de $600 mil pesos por infección evitada. Discusión y conclusión Los servicios de reducción de daños cumplen un papel importante en la reducción de la incidencia de VIH en México. Asegurar su financiamiento es necesario ya que es una herramienta costo-efectiva si se le combina con otras estrategias para reducir la carga económica y de salud pública del VIH/sida.

Gender matters? How does gender shape risk environment for syringe sharing among people who inject drugs in northern Mexico. Results from a cross-sectional survey / ¿Importa el género? Evaluando el género como un componente del entorno de riesgo para el uso compartido de jeringas entre personas que se inyectan drogas en el norte de México. Resultados de una encuesta transversal

Abstract Introduction HIV prevalence among people who inject drugs (PWID) is 5%. Studies have found a HIV prevalence around 10% among women who inject drugs (WWID) and 5% among men. Objective To describe characteristics of risk environment that play different roles among men and women who inject drugs in Mexico that could be associated with those differentials. Method In 2012 were interviewed in Hermosillo and Ciudad Juarez in places where population gathered. From them, 824 PWID 74.0% were men and 26.0% were women. Using chi-square test we analyzed associations of gender with demographics characteristics, drug use dynamics, and injecting behaviors. We fitted different generalized linear mixed models with random effects to test the hypothesis that predictors of receptive needle sharing have different effects on men and women. Results Descriptive analysis showed that women live in conditions of higher vulnerability than men in terms of migration, educational attainment, occupation, and income. Women also reported a higher frequency of drug injection, a higher number of drugs used, and a higher prevalence of sharing needles. Variables significantly associated with the likelihood of sharing needles were: having being injected for someone else at first drug injection (adjusted odds ratio [AOR] = 1.60, 95% confidence interval CI [1.11, 2.25], p < .05); injecting once a day or more (AOR = 1.80, 95% CI [1.17, 2.70], p < .05), using alcohol or drugs at least half of the time at their sexual encounters (AOR = 1.64, 95% CI [1.16, 2.47], p < .05), experience of syringe confiscation by police (AOR = 1.54, 95% CI [1.13, 2.19], p < .05), and perceiving syringe availability as hard or very hard (AOR = 2.29, 95% CI [1.49, 3.32], p < .01). For women the most significant variable associated with syringe sharing was perception of syringe availability (AOR = 3.15, 95% CI [1.25, 7.91], p < .05), while for men was syringe confiscation by police (AOR = 1.74, 95% CI [1.20, 2.50], p < .05). Discussion and conclusion Results suggests the need to design and implement harm reduction programs that tackle the specific need of WID. Enhancing syringe availability through permanent harm reduction programs, implemented in coordination between public health authorities and community-based organizations, is a basic action to stop HIV spreading among PWID in northern Mexico, along with the decriminalization policies towards these population.

Resumen Introducción La prevalencia del VIH entre personas que se inyectan drogas (PIDs) es del 5%. Los estudios han encontrado que la prevalencia del VIH es aproximadamente del 10% entre las mujeres que se inyectan drogas (MIDs) y del 5% entre los hombres. Objetivo Este artículo busca describir detalladamente diferencias en las características que forman ambientes de riesgo diferenciados al VIH entre hombres y mujeres que se inyectan drogas en México. Método Se entrevistó a 824 personas que se inyectan drogas (PIDs) en Hermosillo y Ciudad Juárez en 2012 en lugares de encuentro de población. El 74.0% fueron hombres y el 26.0% mujeres. Mediante la prueba de chi-cuadrada, se caracterizan perfiles sociodemográficos, dinámicas de uso de drogas y de inyección por sexo. Se ajustan diferentes modelos lineales mixtos generalizados para probar la hipótesis que los predictores del uso compartido de jeringas tienen efectos distintos en hombres y mujeres. Resultados El análisis descriptivo mostró que las mujeres viven en condiciones de mayor vulnerabilidad que los hombres en términos de migración, logros educativos, ocupación e ingresos. Las mujeres también informaron una mayor frecuencia de inyección de drogas, mayor número de drogas usadas y mayor prevalencia de uso compartido de jeringas. Las variables significativamente asociadas con la probabilidad de compartir jeringas fueron haber sido inyectado por alguien más al momento de la primera inyección (Razones de momios ajustadas [AOR] = 1.60, 95% intervalo de confianza IC [1.11, 2.25], p < .05), inyectarse una vez al día o más (AOR = 1.80, 95% IC [1.17, 2.70], p < .05), consumir alcohol o drogas en al menos la mitad de sus encuentros sexuales (AOR = 1.64, 95% IC [1.16, 2.47], p < .05), haber enfrentado confiscación de jeringas por parte de la policía (AOR = 1.54, 95% IC [1.13, 2.19], p < .05) y tener una mala percepción de la disponibilidad de jeringas (AOR = 2.29, 95% IC [1.49, 3.32], p < .01). Entre las mujeres, la variable más significativa asociado a la probabilidad de compartir jeringas fue la mala percepción de la disponibilidad de jeringas nuevas (AOR = 3.15, 95% IC [1.25, 7.91], p < .05), mientras que en los hombres fue la experiencia de acoso policial (AOR = 1.74, 95% IC [1.20, 2.50], p < .05). Discusión y conclusión Los resultados sugieren la necesidad de diseñar e implementar programas de reducción de daños que tomen en cuenta las necesidades específicas de las MIDs. Es urgente mejorar la disponibilidad de jeringas entre PWIDs en el norte de México por medio de programas permanentes de reducción de daños, implementados en coordinación entre las autoridades de salud pública y las organizaciones comunitarias y en conjunto con políticas de descriminalización de esta población.

Current Profile of Hepatitis C in Tripura, India

Introduction: Viral hepatitis is one of the common causes of chronic liver disease. Hepatitis C is the second most importantcause of chronic viral hepatitis. Globally, an estimated 71 million people have chronic hepatitis C infection. In 2015, there were1.75 million new hepatitis C virus (HCV) infections. Approximately 399,000 people die each year due to HCV-related cirrhosisand hepatocellular carcinoma. Highest numbers of infections are noted in Egypt. South East Asian region countries are alsohaving high prevalence. The prevalence in India is around 1%. In Tripura, blood bank-based study shows prevalence around0.1%. Higher prevalence was seen in patient on maintenance hemodialysis.Objectives: The study was designed to determine. (1) Mode of transmission of hepatitis C in Tripura, (2) To evaluate genotypicpattern of hepatitis C infection in Tripura, (3) To evaluate coinfection with human immune deficiency virus (HIV)/hepatitis B virus (HBV).Materials and Methods: It was a cross-sectional study done on 60 consecutive hepatitis C patients attended the liver clinic ofHepatitis Foundation of Tripura between January 2018 and December 2018.Results: The study reveals that in this group, 65% hepatitis C patients were males and 35% were females and 63.3% patientsare from rural areas whereas 36.7% patients are from urban areas. Study shows that there is shift of age among hepatitis Cpatients from older to the younger group. It was observed that 5% of hepatitis C patients had coinfection with HIV infectionbut no coinfection with HBV. Regarding mode transmission of hepatitis C, 30% are through blood transmission, 20% throughdrug abuse, 16.7% patients through sexual route, 11.6% patients through dialysis, 1.7% prenatal transmission, and 20%remain unknown. Genotype 3 was 75% (3a was found in 55% and 20% were genotype 3b,) and genotype 1 was 25% (21.7%genotype 1a and 3.3% were genotype 1b). In the study group, 18% were in decompensated chronic liver disease.Discussion: The prevalence of HCV infection seems to be increasing among people who inject drugs in Tripura. Malepreponderance in this study may be due to more exposure to drugs among males. Higher prevalence of Hepatitis C amongthe rural people may be due to increase quackery practice in the rural areas.

Clinical observation of acupuncture combined with acupoint injection in the treatment of post -stroke intractable hiccup / 中国基层医药

Objective To observe the clinical therapeutic effect of acupuncture combined with acupoint injection in the treatment of post -stroke intractable hiccup.Methods 120 patients with post -stroke intractable hiccup were randomly divided into treatment group(60 cases)and control groups(60 cases)according to the digital table.The patients in the control group were treated with baclofen tablets and methloxetamine hydrochloride injection, and the patients in the treatment group were treated with acupuncture combined with acupoint injection therapy.The treating period was 1 week.The scores of hiccup symptoms,the total effective rate and side effect were recorded before and after the treatment in all patients.Results The scores of hiccup symptoms before treatment in the treatment group and the control group were (5.32 ±1.17)points and (5.25 ±0.65)points respectively,there was no statistically significant difference between the two groups(t =1.79,P =0.96).The scores of hiccup symptoms on the 1 day after treatment in the treatment group and the control group were (3.97 ±1.24)points and (3.85 ±1.02 )points respectively,there was no statistically significant difference between the two groups(t =1.93,P =0.48).The scores of hiccup symptoms on the 3 days after treatment in the treatment group and the control group were (2.80 ±0.73)points and (3.75 ±1.11)points respectively,there was significant difference between the two groups(t =2.66,P =0.00), that in the treatment group was lower than the control group.The scores of hiccup symptoms on the 5 days after treatment in the treatment group and the control group were (2.25 ±1.07)points and (3.43 ±0.81)points respec-tively,there was significant difference between the two groups(t =2.85,P =0.00),that in the treatment group was lower than the control group.The scores of hiccup symptoms on the 7 days after treatment in the treatment group and the control group were (1.27 ±0.66)points and (2.02 ±0.98)points respectively,there was significant difference between the two groups(t =1.07,P =0.00),that in the treatment group was lower than the control group.The total effective rates in the treatment group and the control group were 90%(54 /60)and 65%(39 /60)respectively,there was significant difference between the two groups(χ2 =10.75,P =0.00).The incidence rates of side effects in the treatment group and the control group were 1.7%(1 /60)and 6.7%(4 /60)respectively,there was no statistically significant difference between the two groups(χ2 =0.84,P =0.36).Conclusion Acupuncture combined with acu-point injection can significantly reduce the hiccup symptom score of post -stroke intractable hiccup patients on the 3, 5 and 7 days after treatment,and improve the total effective rate.

Polipectomía endoscópica de colon: efectividad y seguridad de la técnica de inyectar y cortar / Efficacy and safety of the inject and cut technique for endoscopic colonic polypectomy

Colonic polypectomy is the most important tool for stopping adenoma-cancer, and the inject and cut technique has demonstrated efficacy and safety in studies conducted in other countries. Since in our country there are no reported data on performance of this technique, it is necessary to describe the experience of a gastroenterology unit of a university. Objectives: The objectives of this study were to describe operational characteristics of endoscopic colonic polypectomy using the inject and cut technique and to describe demographic characteristics of patients undergoing this procedure. Materials and Methods: We included all patients who underwent endoscopic colonic polypectomies in the gastroenterology unit of the Clínica Fundadores in Bogotá from January 2003 to September 2011. Data were processed using SPSS version 18 18.8 (SPSS-IBM) statistical package. Results: 420 patients underwent polypectomies which resected a total of 548 polyps. Mean patient age was 56.3 years (range 14 to 93), 201 patients were male, and 219 were female. Polyps were most commonly located in the left colon (238/64.4%). Average size was 1.6 cm. 83.8% were pedunculated, 13.3% were sessile, and 2.85% were flat. Intraoperative bleeding occurred in 36 cases (8.6%). There was no relationship between this complication and the size of polyps (<= 20vs> 20 mm), OR: 0.44 (CI 0.19-1.01), nor with the number of resected polyps (1Vs> 1) OR: 1.44, (95%:0.65-3 .2). All cases of bleeding were controlled endoscopically without further complications. There was no need for surgery. There were no local recurrences during follow-up. Conclusions: This study showed that the inject and cut technique is a practical, effective, economical and easy to perform technique for removal of colonic polyps. To date this is the largest series published in our country on the subject

Colonic polypectomy is the most important tool for stopping adenoma-cancer, and the inject and cut technique has demonstrated efficacy and safety in studies conducted in other countries. Since in our country there are no reported data on performance of this technique, it is necessary to describe the experience of a gastroenterology unit of a university. Objectives: The objectives of this study were to describe operational characteristics of endoscopic colonic polypectomy using the inject and cut technique and to describe demographic characteristics of patients undergoing this procedure. Materials and Methods: We included all patients who underwent endoscopic colonic polypectomies in the gastroenterology unit of the Clínica Fundadores in Bogotá from January 2003 to September 2011. Data were processed using SPSS version 18 18.8 (SPSS-IBM) statistical package. Results: 420 patients underwent polypectomies which resected a total of 548 polyps. Mean patient age was 56.3 years (range 14 to 93), 201 patients were male, and 219 were female. Polyps were most commonly located in the left colon (238/64.4%). Average size was 1.6 cm. 83.8% were pedunculated, 13.3% were sessile, and 2.85% were flat. Intraoperative bleeding occurred in 36 cases (8.6%). There was no relationship between this complication and the size of polyps (<= 20vs> 20 mm), OR: 0.44 (CI 0.19-1.01), nor with the number of resected polyps (1Vs> 1) OR: 1.44, (95%:0.65-3 .2). All cases of bleeding were controlled endoscopically without further complications. There was no need for surgery. There were no local recurrences during follow-up. Conclusions: This study showed that the inject and cut technique is a practical, effective, economical and easy to perform technique for removal of colonic polyps. To date this is the largest series published in our country on the subject

Effects of reduning inject a liquid for EV71 infection cases / 中国基层医药

Objective To observe the effect of reduning inject a liquid in the treatment of EV71 infection cases.Methods The 52 cases were randomly divided into two groups by random number table.The treatment group were given reduning inject a liquid.The control group were given the treatment of Ribavirin inject.Observed and compared two groups of efficacy and Prognosis and adverse reactions.Results Prognosis of the observation group were Significantly better than the control group(x2 =5.016,P ＜ 0.05).Cooling time and deflorescence time of the observation group were shorter than the control group (t =3.475,3.687,P ＜ 0.05),the effect of fever and rash were significantly higher than the control group (x2 =6.272,6.349,P ＜ 0.05).Conclusion It is valid and safety method in the treatment of EV71 infection cases with the reduning inject a liquid,and worth popularizing.

The research of vaccine safety injection and the best disinfection effect of using alcohol / 中国实用护理杂志

Objective This article is to discuss the best injection time after alcohol disinfection during the prophylactic immunization,provide theoretical support to guarantee the effect of disinfection in practical work,also guarantee the effect of vaccination especially for the vaccination of attenuated live vaccine at the same time reduce the side effect in disinfection.Methods Choosing the vaccination objects as experimental subject,each period contained 40 people,who were named as group A,B,C,D,E,with a total of 200 people.Using sterile cotton swab sampling and agar plate cultivation method,counting bacteria.Selecting vaccine either in liquid or in lyophilized form,counting the time of picking up the vaccine,dissolving it,suction and preparing the injector.Results After alcohol disinfection,there was 1 person and 1 colony growth in group A within 25 s.There were 1 person and 4 colonies growth in group B within 40 s.There were 3 persons and 3 to 12 colonies growth in group C within 60 s,there were 5 persons and 2 to 8 colonies growth in group D within 80 s,there were 8 persons and 3 to 13 colonies growth in group E within 100 s.The difference between group A,B,C and D was not statistically significant.All four groups mentioned above had significant difference compared with group E.The time of whole process for vaccine either in liquid or in lyophilized form was 1.05 min and 29 s.Conclusions During vaccine injection,especially injectable attenuated live vaccine,it is safe time to finish injecting within 25 to 45 seconds.In the operating process of vaccine inoculation,the freeting and drying dosage-form vaccine,the operation sequence must be set as dissolve the seedlings,disinfection,checkup information again and injections.For water dosage-form vaccine,the operation sequence is to disinfection,pulling out seedlings,checkup information again and injections.

Knowledge and attitude of HIV/AIDS prevention among young people from 15-24 years old in Quang Tri, An Giang and Kien Giang provincies

Background: \r\n', u'In Vietnam, the HIV/AIDS epidemic has tended towards young people. The fact is that there is more than 40 % of HIV/AIDS at infections at the age of 15-24 years olds nationwide. The HIV/AIDS infections among the youth are identified as the potential threat to eco- social development and security order of the country\r\n', u'Objectives: \r\n', u'To make a survey of knowledge and attitude of among young people from 15 to 24 years olds towards HIV/AIDS prevention in Quang Tri, An Giang and Kien Giang provinces.\r\n', u'Subjects and method: \r\n', u'1.435 single people aged from 15 to 24 years old, lived in Quang Tri, An Giang, Kien Giang provinces, were studied , directly interviewedon the knowledge and attitude toward HIV/AIDS prevention.\r\n', u'Results:\r\n', u'The rate of subjects with sufficient and correct knowledge on 3 ways of HIV/AIDS transmission was 67.9%, and with HIV/AIDS prevention method was 60.1%, 97.7% of the subjects had the attitude to look after their HIV (+) close relatives. 64.8% of the subjects agreed to allow a teacher with HIV (+) to continue his/her teaching, and 63.3% - 93% accepted to behave in normal relationship with the HIV infected.\r\n', u'Conclusion: Enhance the communication, education and communication on HIV / AIDS to improve awareness and practice of preventive measures against HIV / AIDS for young people\r\n', u'

Ethanol Injection Treatment of Simple Clinical Study of Breast Cysts / 医学研究杂志

Objective To investigate the therapeutic efficacies for pure galactoma by injecting absolute ethanol compared with the pure pouch cavity puncture separately pulls out the fluid law.Methods Patients of pure galactoma examined by ultrasonography were divided into two groups from March of 2005 to February of 2007 in mammary gland special clinic of our hospital.Absolute ethanol jet method and the pure pouch cavity puncture separately pulls out the fluid law were given respectively and the effect was evaluated within one year after operation.Results Of 89 cases pure galactoma using absolute ethanol jet method,71cases(79.78%)were convalesced,15cases(16.85%)were effective and 3 cases(3.37%)were noneffective.The effectiveness was 96.63 %.Of 86 cases using pure pouch cavity puncture separately pulls out the fluid law,44cases(51.16%)were convalesced,33 cases(38.37%)were effective and 9 cases(10.47%)were noneffective.The effectiveness was 89.53%.The cured rates of two groups had significant difference through chi-square test,?2=15.38,P

Evaluation of a new approach that inject bilirubin solution into cerebellomedullary cistern to establish bilirubin encephalopathy model in neonatal mouse / 重庆医科大学学报

Objective:To evaluate the feasibility of animal model of bilirubin encephalopathy by injecting bilirubin solution into cerebellomedullary cistern of neonatal full-term and premature mice.Methods:Thirty 7-day-old mice were randomly divided into 5 groups:control group,model group 1,model group2,model group3,and model group4.Bilirubin solution was injected into the cerebellomedullary cistern in model groups(bilirubin 20?g/g bodyweight),while equal volume of normal saline was injected into the cerebellomedullary cistern in control group.The mice in model groups were sacrificed at the time of 12h,24h,48 and 72h after injection,respectively,and those in control group were sacrificed at 24h after injection.The apoptosis and necrosis of neurocytes,the expressions of Bcl-2 and Bax proteins were detected by HE stain,immunohistochemical method and TUNEL in the hippocampus,respectively.Preterm mice were delivered by cesarean section at 21 days gestation and fed by surrogate mother mouse until 7 days old.Bilirubin solution was injected into their cerebellomedullary cistern.The mice's abnormal behaviors were observed.Results:The mice of model groups and preterm group appeared abnormal behaviors in different degree.Under light microscope,the neurocytes in their hippocampus appear apoptosis and necrosis.The nissl body in pyramidal cell body and dendron decreased,even dissolved to disappear.TUNEL showed that the apoptosis rate in the hippocampus increased obviously at 12h post-injection,reached the peak at 24h post-injection.The positive rate of Bax protein in the hippocampus reached the peak at 24h post-injection,while the positive rate of Bcl-2 protein decreased to the lowest.Conclsions:The method that injecting bilirubin solution into neonatal mice' cerebellomedullary cistern to set up the animal model of bilirubin encephalopathy is simple and feasible.The peak time of neurocytes' apoptosis in hippocampus was 24h post-injection.It's crucial to prevent bilirubin encephalopathy as early as possible.