Abildgaardbeach1776
Hip fractures of the elderly population are a common trauma and numbers are increasing due to ageing societies. Although this is an ordinary low energy impact injury and surgical repair techniques show good results, the perioperative course is characterized by an unparalleled disproportionate perioperative morbidity and mortality.
Most studies focus on outcome-related data. Little is known on how to prevent and treat adverse sequelae, ranging from mild physical challenges to neurobiological disorders and death.
Although the contribution of the anaesthetic technique per se seems to be small, the role of the anaesthesiologist as a perioperative physician is undisputed. From focusing on comorbidities and initiating preoperative optimization to intraoperative and postoperative care, there is a huge area to be covered by our faculty to ensure a reasonable outcome defined as quality of postoperative life rather than merely in terms of a successful surgical repair. Protocol-driven perioperative approaches shou the socioeconomic load for society.
To establish a prediction model of malignancy for solitary pulmonary nodules (SPNs) on the basis of imaging, clinical characteristics and tumor marker levels.
Totally, 341 cases of SPNs were enrolled in this retrospective study, in which 70% were selected as the training group (n = 238) and the rest 30% as the verification group (n = 103). The imaging, clinical characteristics and tumor marker levels of patients with benign and malignant SPNs were compared. Influencing factors were identified using multivariate logistic regression analysis. The model was assessed by the area under the curve (AUC) of the receiver operating characteristic curve.
Differences were evident between patients with benign and malignant SPNs in age, gender, smoking history, carcinoembryonic antigen (CEA), neuron-specific enolase, nodule location, edge smoothing, spiculation, lobulation, vascular convergence sign, air bronchogram, ground-glass opacity, vacuole sign and calcification (all P < 0.05). Influencing factors for malignancy included age, gender, nodule location, spiculation, vacuole sign and CEA (all P < 0.05). The established model was as follows Y = -5.368 + 0.055 × age + 1.012 × gender (female = 1, male = 0) + 1.302 × nodule location (right upper lobe = 1, others = 0) + 1.208 × spiculation (yes = 1, no = 0) + 2.164 × vacuole sign (yes = 1, no = 0) -0.054 × CEA. The AUC of the model with CEA was 0.818 (95% confidence interval, 0.763-0.865), with a sensitivity of 64.80% and a specificity of 84.96%, and the stability was better through internal verification.
The prediction model established in our study exhibits better accuracy and internal stability in predicting the probability of malignancy for SPNs.
The prediction model established in our study exhibits better accuracy and internal stability in predicting the probability of malignancy for SPNs.
Cancer survivors (CSs) have needs that can negatively impact their quality of life (QoL). Oncology nurses play a key role in providing comprehensive care in cancer survivorship, although little is known about their impact on health outcomes.
The aim of this study was to determine the effectiveness of nursing interventions to improve QoL and satisfaction with care of CSs.
A systematic review was conducted. PubMed, CINAHL, PsycINFO, and Cochrane databases were searched for experimental studies. The Joanna Briggs Institute Checklist for Randomized Controlled Trials was used to verify the quality of the studies (Prospero reference CRD42020148294).
Of the 8 clinical trials eligible for inclusion, 5 demonstrated that interventions conducted by nurses improved the overall QoL or some of its domains in CSs. The included studies focused on short-term survival; no studies in long-term CSs were identified. read more Two studies assessed satisfaction with care of survivors, obtaining positive results.
Nursing interventions seem to improve the QoL of short-term CSs. However, because of the low number of studies identified, the findings of this systematic review should be interpreted with caution.
Further studies are necessary to strengthen the implementation of effective nursing intervention in cancer practice. Research should particularly be conducted with long-term CSs as there is lack of data on this specific stage of cancer.
Further studies are necessary to strengthen the implementation of effective nursing intervention in cancer practice. Research should particularly be conducted with long-term CSs as there is lack of data on this specific stage of cancer.
Lichen sclerosus (LS), a chronic inflammatory dermatosis localized in the anogenital region, is known to be associated with lower urinary tract symptoms (LUTS) in postmenopausal women; however, there is a paucity of data on prepubertal girls. We sought to characterize the relationship between LS, LUTS, and constipation among premenarchal girls.
We conducted a retrospective chart review of premenarchal girls presenting at the pediatric adolescent gynecology and pediatric urology clinics at our institution diagnosed with vulvar LS during a 4-year period. Demographics, clinical presentation, time from onset of urinary and/or bowel symptoms to LS diagnosis, and treatment response were assessed. Analysis was completed using median, range, and nonparametric statistical analysis where appropriate.
Nineteen premenarchal girls with LS met inclusion criteria. The median age at LS diagnosis was 6.2 years (range = 3.3-13.3 yrs). Most girls (12/19, 63.2%) presented with LUTS during LS evaluation, and 11 (57.9%) of 19 patients had constipation. Pruritus and hypopigmentation were the most frequently encountered LS symptom and sign, respectively. Fourteen (73.7%) of the 19 girls had resolution/improvement of LS symptoms after LS treatment. Of the 12 patients with LUTS, 7 (58.3%) had resolution/improvement of LUTS symptoms, 3 (25.0%) had unchanged voiding symptoms, and 2 (16.7%) had unknown changes.
Although further studies are needed to better characterize the relationship between LUTS, constipation, and LS, our findings suggest that premenarchal subjects presenting with LUTS should be assessed for LS. Likewise, patients presenting with LS should be assessed for LUTS and constipation.
Although further studies are needed to better characterize the relationship between LUTS, constipation, and LS, our findings suggest that premenarchal subjects presenting with LUTS should be assessed for LS. Likewise, patients presenting with LS should be assessed for LUTS and constipation.