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00 per 10% stratum). In contrast, increased age and higher tumor stage were the most important factors determining whether patients underwent surgery. Patients with higher SES were less likely to undergo mastectomy (OR 0.98). Additionally, more recently diagnosed patients were less likely to undergo mastectomy (OR 0.93 per year) while patients with higher tumor stage were more likely to undergo mastectomy (OR 3.42).
SES does not affect whether a patient undergoes surgery; however, higher SES increased the likelihood of BCT.
SES does not affect whether a patient undergoes surgery; however, higher SES increased the likelihood of BCT.
Since the occurrence of the SARS-COV2 pandemic, there has been an increasing interest in investigating the epidemiology of delirium. Delirium is frequent in SARS-COV2 patients and it is associated with increased mortality; however, no information is available on the association between delirium duration in SARS-COV2 patients and related outcomes.
The aim of this study is to investigate the association between the duration of delirium symptoms and in-hospital mortality in older patients with SARS-COV2 infection.
Retrospective cohort study of patients 65years of age and older with SARS-CoV 2 infection admitted to two acute geriatric wards and one rehabilitation ward. Delirium symptoms duration was assessed retrospectively with a chart-based validated method. In-hospital mortality was ascertained via medical records.
A total of 241 patients were included. The prevalence of delirium on admission was 16%. The median number of days with delirium symptoms was 4 (IQR 2-6.5) vs. 0 (IQR 0-2) in patients with and without delirium on admission. In the multivariable Cox regression model, each day with a delirium symptom in a patient with the same length of stay was associated with a 10% increase in in-hospital mortality (Hazard ratio 1.1, 95% Confidence interval 1.01-1.2; p = 0.03). Other variables associated with increased risk of in-hospital death were age, comorbidity, CPAP, CRP levels and total number of drugs on admission.
The study supports the necessity to establish protocols for the monitoring and management of delirium during emergency conditions to allow an appropriate care for older patients.
The study supports the necessity to establish protocols for the monitoring and management of delirium during emergency conditions to allow an appropriate care for older patients.Electromyographic biofeedback (EMG-BF) can be regarded as an adjuvant to pelvic floor muscle (PFM) training (PFMT) for the management of stress urinary incontinence (SUI). This meta-analysis aimed to compare the efficacy of PFMT with and without EMG-BF on the cure and improvement rate, PFM strength, urinary incontinence score, and quality of sexual life for the treatment of SUI or pelvic floor dysfunction (PFD). PubMed, EMBASE, the Cochrane Library, Web of Science, Wanfang, and CNKI were systematically searched for studies published up to January 2021. The outcomes were the cure and improvement rate, symptom-related score, pelvic floor muscle strength change, and sexual life quality. Androgen Receptor animal study Twenty-one studies (comprising 1967 patients with EMG-BF + PFMT and 1898 with PFMT) were included. Compared with PFMT, EMG-BF + PFMT had benefits regarding the cure and improvement rate in SUI (OR 4.82, 95% CI 2.21-10.51, P less then 0.001; I2 = 85.3%, Pheterogeneity less then 0.001) and in PFD (OR 2.81, 95% CI 2.04-3.86, P less then 0.001; I2 = 13.1%, Pheterogeneity = 0.331), and in quality of life using the I-QOL tool (SMD 1.47, 95% CI 0.69-2.26, P less then 0.001; I2 = 90.1%, Pheterogeneity less then 0.001), quality of sexual life using the FSFI tool (SMD 2.86, 95% CI 0.47-5.25, P = 0.019; I2 = 98.7%, Pheterogeneity less then 0.001), urinary incontinence using the ICI-Q-SF tool (SMD - 0.62, 95% CI - 1.16, - 0.08, P = 0.024), PFM strength (SMD 1.72, 95% CI 1.08-2.35, P less then 0.001; I2 = 91.4%, Pheterogeneity less then 0.001), and urodynamics using Qmax (SMD 0.84, 95% CI 0.57-1.10, P less then 0.001; I2 = 0%, Pheterogeneity = 0.420) and MUCP (SMD 1.54, 95% CI 0.66-2.43, P = 0.001; I2 = 81.8%, Pheterogeneity = 0.019). There was limited evidence of publication bias. PFMT combined with EMG-BF achieves better outcomes than PFMT alone in SUI or PFD management.
The aim was to investigate pulmonary function after surgical correction of adult idiopathic scoliosis.
This study included 146 adult scoliosis patients aged 20-50years (main curve in thoracic spine). Respiratory function was assessed as predicted forced vital capacity (%FVC) and the ratio of forced expiratory volume in 1s / FVC (%FEV
) preoperatively and 2years postoperatively and classified as a normal function (≥ 80%), mild impairment (≥ 65% and < 80%), and moderate impairment (< 65%).
Preoperative %FVC and %FEV
were 85.3% and 85.4%, which were 81.5% and 87.5% at 2years post-surgery. The preoperative %FVC was mild and moderate in 39 (26.7%) and 12 patients (11.6%), respectively. The %FVC significantly improved (+ 6.2% ± 11.4%, P < 0.001) postoperatively for moderate severity but significantly decreased postoperatively (- 6.4% ± 9.4%, P < 0.001) for normal function. The preoperative %FEV
was mild and moderate in 27 (18.5%) and 0 patients, respectively. The %FEV1 significantly improved postoperatively (6.3% ± 5.3%, P < 0.001) for mild severity but did not significantly change for normal severity. Twenty-three (15.8%) and 41 (28.1%) patients showed improved ⊿%FVC and ⊿% FEV
> 5%. Logistic regression analysis showed that preoperative %FVC and %FEV
severities were independent factors affecting postoperative recovery of %FVC (OR 0.95) and %FEV
(OR 0.85).
Pulmonary function improved in patients with preoperative pulmonary impairment of < 65% in %FVC and < 80% in %FEV
, and the real improvement was limited to patients with severe preoperative impairment.
Pulmonary function improved in patients with preoperative pulmonary impairment of less then 65% in %FVC and less then 80% in %FEV1, and the real improvement was limited to patients with severe preoperative impairment.
