Chappellhoover7149
To explore the accuracy related to type and subtype between frozen section (FS) results and final pathology results in patients with endometrial cancer and to suggest whether it should be routinely performed.
Retrospective data were collected from 184 patients with endometrial cancer who underwent surgery at a single center (January 2014-December 2018). FS results were compared with the final pathology results with respect to histotype, tumor grade, and depth of invasion to define the accuracy of FS analysis.
Frozen section analysis was performed in 141 (76.6%) patients. The accuracy rates and κ values between the FS and final pathology results with respect to histotype, tumor grade, and depth of invasion were 87.23%, 81.15%, and 98.2% and 0.41, 0.7, and 0.9, respectively (P<0.001). Among the 18 patients with preoperative non-endometrioid cancer (non-EC), six underwent FS analysis, and final pathology confirmed EC in three, of whom 75% were detected by FS analysis. Eight of 19 patients with preoperative grade 3 EC underwent FS analysis and the accuracy rate was 87.5%.
Intraoperative FS analysis is a reliable method that can help intraoperative decision making. It should be performed routinely in patients with non-EC and grade 3 EC.
Intraoperative FS analysis is a reliable method that can help intraoperative decision making. It should be performed routinely in patients with non-EC and grade 3 EC.
Health-related quality of life (HRQoL) and the delivery of high-quality care are ongoing concerns when caring for pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. We compared self-reported HRQoL and hospital quality of care among perinatal women with and without COVID-19.
This is a prospective cohort study of perinatal women attending a tertiary maternity unit during the pandemic. Eighteen women who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 20 SARS-CoV-2-negative women were recruited. Participants completed the Short Form Health Survey (SF-12), Clinical Outcomes in Routine Evaluation-Outcome Measure, and Quality from the Patient's Perspective questionnaires. Mean scores were compared.
Of the Non-COVID-19 cohort, 95% (n = 19) were Caucasian, whereas 67% (n = 12) of the COVID-19 cohort were not Caucasian (χ
=16.01, P<0.001). The mean SF-12 for physical health in the COVID-19 cohort had significantly lower scores (P<0.002). There was no difference in mental health and well-being between cohorts. The quality of care experienced was notably similar and very positive.
There was a significantly greater burden on physical health among pregnant women with COVID-19. Mental health and psychological status were similar in both groups. High quality of care during a pandemic is possible to deliver in a maternity setting, irrespective of COVID-19 status.
There was a significantly greater burden on physical health among pregnant women with COVID-19. Mental health and psychological status were similar in both groups. High quality of care during a pandemic is possible to deliver in a maternity setting, irrespective of COVID-19 status.
The extant literature is inconsistent over whether manic symptoms in first-episode psychosis (FEP) impact on its development and trajectory. This study addressed the following (1) Does Duration of Untreated Illness (DUI) and Duration of Untreated Psychosis (DUP) differ between FEP patients with and without manic symptoms? (2) Do manic symptoms in FEP have an impact on time to remission over 1year?
We used data from the National EDEN study, a longitudinal cohort of patients with FEP accessing early intervention services (EIS) in England, which measured manic, positive and negative psychotic symptoms, depression and functioning at service entry and 1year. Data from 913 patients with FEP (639 without manic symptoms, 237 with manic symptoms) were analysed using both general linear modelling and survival analysis.
Compared to FEP patients without manic symptoms, those with manic symptoms had a significantly longer DUI, though no difference in DUP. At baseline, people with manic symptoms had higher levels of positive and negative psychotic symptoms, depression and worse functioning. At 12months, people with manic symptoms had significantly poorer functioning and more positive psychotic symptoms. The presence of manic symptoms delayed time to remission over 1year. There was a 19% reduced rate of remission for people with manic symptoms compared to those without.
Manic symptoms in FEP are associated with delays to treatment. Zongertinib inhibitor This poorer trajectory persists over 1year. They appear to be a vulnerable and under-recognised group for poor outcome and need more focussed early intervention treatment.
Manic symptoms in FEP are associated with delays to treatment. This poorer trajectory persists over 1 year. They appear to be a vulnerable and under-recognised group for poor outcome and need more focussed early intervention treatment.
Sepsis is common, deadly, and a major challenge to treat. Quinolones added to beta-lactam antibiotics are currently recommended as a second-line empiric regimen in sepsis, but the evidence regarding their benefits and harms is unclear.
To assess the benefits and harms of adding quinolones to standard care for sepsis.
We conducted a systematic review of randomized clinical trials with meta-analysis and Trial Sequential Analysis. We searched CENTRAL, MEDLINE, Embase, LILACS, SCI-Expanded, and BIOSIS.
Randomized clinical trials assessing the effects of adding any quinolone to standard care for children and adults with sepsis.
Two independent reviewers screened studies and extracted data. The certainty of the evidence was assessed by GRADE.
We included three trials randomizing 995 adults. All trials were at overall "high risk of bias." All trials compared a quinolone (moxifloxacin, levofloxacin, or ciprofloxacin) and a beta-lactam antibiotic versus the same beta-lactam antibiotic. We found no evidence of an effect of adding quinolones to beta-lactam antibiotics when assessing all-cause mortality (RR 1.07, 95% CI 0.86 to 1.33; 2 trials; 915 participants; very low certainty of evidence) and serious adverse events (RR 1.00, 95% CI 0.67 to 1.50; 977 participants; two trials; very low certainty of evidence). No trials reported on quality of life.
The effects of adding quinolones to beta-lactam antibiotics for the treatment of sepsis were unclear for all outcomes. Additional trial data are warranted to support the recommendation of empirical use of quinolones for sepsis.
The effects of adding quinolones to beta-lactam antibiotics for the treatment of sepsis were unclear for all outcomes. Additional trial data are warranted to support the recommendation of empirical use of quinolones for sepsis.