Steffensenweiss6960
pain management may help alleviate patients' pain after surgery and reduce variety of pain management practices among nurses.
To explore postanesthesia care unit (PACU) nurses' experiences and perception of patient participation during PACU care.
Qualitative focus group study based on a phenomenological hermeneutic approach.
We conducted three focus group interviews with 18 nurses from three different PACUs. Themes were created based on interpretive theory inspired by Ricoeur.
Four themes and 11 subthemes were found. Patients' clinical condition and situation, time management, ethical aspects, and the patient-nurse relationship all had a high impact on postanesthesia nursing practice and conditions for involving patients.
PACU nurses want patients to participate in their own treatment and care in the PACU; however, nurses perceive patient participation differently. Nurses experience challenges including patients' impaired autonomy, absence of a holistic approach, and lack of time and resources. Nurses highlight that these barriers should not become an excuse for noninvolvement.
PACU nurses want patients to participate in their own treatment and care in the PACU; however, nurses perceive patient participation differently. Nurses experience challenges including patients' impaired autonomy, absence of a holistic approach, and lack of time and resources. Nurses highlight that these barriers should not become an excuse for noninvolvement.
The relationship of water intake with kidney function in the population is uncertain. This study investigated cross-sectionally and longitudinally the relationship of the intake of water and other beverages with kidney function within an adult Italian population sample.
In 4,554 Gubbio Study examinees (54.4% women, age 18-95years), data collection at baseline included demographics, anthropometry, questionnaires on habitual intakes of water and other beverages (non-water fluids), a timed overnight urine collection, estimated glomerular filtration rate (eGFR), decreased eGFR (<60mL/minute/1.73m
), and other variables including urinary markers of diet. At 15-year follow-up, the incidence of renal/kidney replacement therapy, the eGFR change from baseline, and the incidence of decreased eGFR were used as indices of kidney function change over time.
In multivariable analyses, higher water intake is independently related to higher urine flow (beta=0.163, P<.001), lower urine osmolality (beta=0.184, P< in the population.
Zinc is essential for human nutrition and plays an important role in hemodialysis (HD) patients. The aim of this study is to analyze the relationship between zinc intake and mortality in HD patients.
This is a longitudinal, prospective, multicenter study with 582 HD patients from 37 dialysis centers. We recorded clinical and body composition parameters. Dietary intake and physical activity data were obtained using the Food Frequency Questionnaire and International Physical Activity Questionnaire. All statistical tests were performed using SPSS 24.0 software. A P value lower than 0.05 was considered statistically significant.
Patients' mean age was 67.8±17.7years and median HD vintage was 65 (43-104) months. About 53.6% of the patients presented a deficient daily intake of zinc. Patients with the highest zinc intake were those who had a higher lean tissue index (P=.022), energy (P<.001), and protein (p=.022) intakes. Zinc intake was positively correlated with energy (r=0.709) and protein intake (r=0.805) and negatively correlated with the malnutrition screening tool score (r=-0.087). A higher energy, protein, and lower carbohydrates intake, as well as lower HD vintage and higher lean tissue index were predictors of zinc intake. A higher mortality risk was observed in patients with zinc intake below the recommended values, even after the adjustment for age, presence of diabetes, gender, dialysis vintage, albumin, lean tissue index, energy intake/kilogram, and level of physical activity (P=.021).
There is a high prevalence of HD patients with an inadequate zinc intake, which is related to worse nutritional and body composition parameters and with a higher mortality risk.
There is a high prevalence of HD patients with an inadequate zinc intake, which is related to worse nutritional and body composition parameters and with a higher mortality risk.
Renal failure and hepatic cirrhosis are mutually aggravating factors. However, no specific therapeutic strategies for hepatic encephalopathy (HE) and end-stage kidney disease have been established. The coexistence, with an extremely poor prognosis, makes randomized controlled trials unfeasible. We evaluated whether an infusion of branched-chain amino acids was associated with mortality in patients hospitalized for HE and end-stage kidney disease.
Using the Japanese Diagnosis Procedure Combination database, we retrospectively identified patients with HE and end-stage kidney disease who received hemodialysis within 2days of admission from July 2011 to March 2017. We divided the patients into those who received branched-chain amino acid infusion within 2days of admission and those who did not. We conducted analyses using overlap weights based on propensity scores to compare in-hospital mortality between the groups. Sub-group analysis was conducted by stratifying patients by Child-Pugh class.
We identified ts with end-stage kidney disease.
Overdose is a major cause of morbidity and mortality among people who use opioids. Naloxone can reverse opioid overdoses and can be distributed and administered with minimal training. People with experience of overdose are a key population to target for overdose prevention strategies. This study aims to understand if factors associated with recent non-fatal opioid overdose are the same as factors associated with naloxone access and naloxone training in people who recently used opioids or received opioid agonist treatment (OAT).
ETHOS Engage is an observational study of people who inject drugs in Australia. Logistic regression models were used to estimate odds ratios for non-fatal opioid overdose, naloxone access and naloxone training.
Between May 2018-September 2019, 1280 participants who recently used opioids or received OAT were enrolled (62% aged >40 years; 35% female, 80% receiving OAT, 62% injected drugs in the preceding month). Recent opioid overdose (preceding 12 months) was reported by 7% of overdose correspond to factors associated with naloxone access. Naloxone access and training is low across all groups. Additional interventions are needed to scale up naloxone provision.
Little is known about the relationship between short-term incarceration and risk of hepatitis C virus (HCV) infection among people who inject drugs (PWID). We investigated whether varying patterns of recent incarceration lasting less than two years are associated with HCV acquisition risk in this population.
We followed prospectively PWID at risk of acquiring HCV infection in Montréal (2004-2019). At 6-month (up until 2011), then 3-month intervals, participants were tested for HCV antibodies or RNA, and self-reported whether they have been incarcerated in each of the previous 6 or 3 months. If incarcerated, they reported the setting and time spent in incarceration. We fit three separate multivariable time-updated Cox regression models, one for each measure of incarceration any incarceration lasting less than two years (yes/no), incarceration stratified by setting (local police station/provincial prison/no) and incarceration stratified by time in incarceration (≤1 week/>1 week and ≤1 month/>1 month a incarceration lasting less than two years, regardless of the setting and time in incarceration, was associated with an elevated risk of HCV acquisition among PWID. Findings support the need to expand access to harm-reduction programs in short-term incarceration settings and, in parallel, to prioritise public health-oriented alternatives to incarcerating PWID where possible.Oncocytic carcinoma of the salivary glands is an extremely rare malignant neoplasm. The parotid is the most frequently involved salivary gland, but tumours in the submandibular gland and minor salivary glands have also been described. It appears that oncocytic carcinoma of an ectopic salivary gland has not been reported so far. The unique case of a 78-year-old male patient diagnosed with oncocytic adenocarcinoma of an ectopic salivary gland is reported here. The patient underwent surgery and adjuvant radiotherapy. The clinical, morphological, and immunohistochemical features of this rare entity are also described.Enhanced osseointegration and a shortened healing time are required for dental implant treatment. The aim of this study was to evaluate whether topical application of the osteogenic inducer (OI) sustained-release system over the implant promotes early bone remodeling around the implant. The mandibular canines of 15 New Zealand White rabbits were extracted. After 3 months of healing, implants coated with poly(lactic-co-glycolic acid) (PLGA)+OI, PLGA alone, or no material (control) were inserted into the canine sites. After 4 weeks, specimens were harvested from the three groups and evaluated. Sunitinib concentration Implant stability recorded by Periotest revealed significantly higher values for the PLGA + OI group (-2.61 ± 0.43) than for the PLGA (-1.47 ± 0.45) and control groups (-1.08 ± 0.19) (P less then 0.001). Moreover, the PLGA+OI group had improved bone volume and structural parameters around the implants at 4 weeks, as shown by significantly increased BV/TV, BSA/BV, Tb.Th, and BIC (P less then 0.05), as well as decreased Tb.Sp (P = 0.010) compared with the other groups. The histological results showed more trabecular bone and bone matrix around the implants in the PLGA+OI group. Therefore, local application of the OI sustained-release system might be able to promote early bone remodeling around titanium implants and facilitate faster and better osseointegration.
International reporting of epidemiological surveys of spinal muscular atrophy (SMA) in Japan has been limited to Shikoku, despite the epidemiology of the disease in countries worldwide becoming clearer. Treatments of 5q-SMA have been developed, and epidemiological studies are needed.
This study aimed to conduct a nationwide epidemiological survey of SMA in Japan to clarify the actual situation of SMA in Japan.
Patients with all clinical types of SMA, including neonates and adults, were selected from 1,005 medical facilities in Japan.
As of December 2017, the actual number of reported patients with SMA was 658 and the genetic testing rate was 79.5%. The estimated number of patients was 1,478 (95% confidence interval (CI), 1,122-1,834), with a prevalence of 1.17 (95%CI, 0.89-1.45) per 100,000 people and an incidence of 0.51 (95%CI, 0.32-0.71) per 10,000 live births. Incidence rates of 5q-SMA by clinical type were 0.27 (95%CI, 0.17-0.38) and 0.08 (95%CI, 0.04-0.11) per 10,000 live births for type 1 and 2, respectively, in cases with a definitive diagnosis by genetic testing. We found that 363 cases (82.7%) occurred less than 2years and 88 (20.0%) occurred age of 2 months old or under.
This study clarifies the prevalence and incidence of SMA in Japan. As infantile onset accounts for most cases of SMA, newborn screening and subsequent treatment are important to save lives.
This study clarifies the prevalence and incidence of SMA in Japan. As infantile onset accounts for most cases of SMA, newborn screening and subsequent treatment are important to save lives.