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Among the high VTE risk elderly patients, the number of patients receiving mechanical prophylaxis in the high bleeding-risk group was higher than that in the low bleeding-risk group (P<0.0001).
Elderly patients in the ICU have the highest risk of VTE and high bleeding risk; decisions concerning clinical prophylaxis should be made after appropriate information on the risk and benefit on an individual level is considered.
Elderly patients in the ICU have the highest risk of VTE and high bleeding risk; decisions concerning clinical prophylaxis should be made after appropriate information on the risk and benefit on an individual level is considered.
Identification of risk factors for poor prognosis of patients with coronavirus disease 2019 (COVID-19) is necessary to enable the risk stratification and modify the patient's management. Thus, we performed a systematic review and meta-analysis to evaluate the in-hospital mortality and risk factors of death in COVID-19 patients.
All studies were searched via the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang databases. The in-hospital mortality of COVID-19 patients was pooled. Odds ratios (ORs) or mean difference (MD) with 95% confidence intervals (CIs) were calculated for evaluation of risk factors.
A total of 80 studies were included with a pooled in-hospital mortality of 14% (95% CI 12.2-15.9%). Older age (MD =13.32, 95% CI 10.87-15.77; P<0.00001), male (OR =1.66, 95% CI 1.37-2.01; P<0.00001), hypertension (OR =2.67, 95% CI 2.08-3.43; P<0.00001), diabetes (OR =2.14, 95% CI 1.76-2.6; P<0.00001), chronic respiratory disease (OR =3.55, 95% Ce risk stratification system.
Advanced age, male, comorbidities, increased levels of acute inflammation or organ damage indicators, and complications are associated with the risk of mortality in COVID-19 patients, and should be integrated into the risk stratification system.
Post-herpetic neuralgia (PHN) is the most common complication of herpes zoster and is defined as pain that lasts for one month or more after the outbreak itself heals. While the annual incidence of herpes zoster is approximately 3-5%, 9-34% of these patients will develop PHN. Approximately 30-50% of these cases last for more than a year but some cases can persist for 10 years or more. To date, the economic burden of PHN in China has not been studied. PF-06873600 The first-line topical therapy for PHN is application of lidocaine-medicated plasters (LMPs) which have shown good efficacy and tolerability. Furthermore, LMPs were added to China's National Health Insurance List in 2019, thereby significantly relieving the financial burden on patients. A cost-effectiveness analysis was performed on LMPs compared with pregabalin in the treatment of PHN to provide a reference for the basis for clinical treatments and health decisions in patients with PHN.
A Markov model was built according to the PHN disease characteristics. Tn reduce the economic burden of patients with PHN. LMPs are more cost-effective and more efficient in absolute terms compared to the first-line treatment systemic drug pregabalin in the treatment of PHN.
Within the Chinese medical and health system, LMPs can reduce the economic burden of patients with PHN. LMPs are more cost-effective and more efficient in absolute terms compared to the first-line treatment systemic drug pregabalin in the treatment of PHN.
Malnutrition dramatically increases the risk of postoperative complications and delays patient recovery. Therefore, a feeding jejunostomy tube (FJT) is routinely placed during esophagectomy to maintain the postoperative nutrition supply. However, recently published studies have questioned the need of a FJT in every esophageal cancer patient. Because most patients can resume oral intake shortly after surgery, the nutrition-providing function of a FJT becomes much less critical. In contrast, FJT-related complications could be severe.
Relevant publications were found out by systemic searching of four medical databases (PubMed, EMBASE, Medline, and Cochrane Center Register of Controlled Trials). By reading the titles and the abstracts, potentially relevant studies were screened from the search results. The incidence of postoperative complications and FJT-related complications were calculated and compared to evaluate the efficacy of a FJT.
Eighteen studies were included in the meta-analysis. The no-FJT groupmplications. Therefore, an intraoperative FJT should be selectively prescribed, but not routinely in the surgical treatment of esophageal cancer.
The aim of the present study was to explore the clinical effect and to predict the prognosis of severe craniocerebral injury patients with decompressive craniectomy by combining transcranial Doppler (TCD) and invasive intracranial pressure (ICP).
A total of 60 severe craniocerebral injury patients with decompressive craniectomy, who were admitted to Shantou Central Hospital from June 2017 to March 2019, were enrolled in this retrospective study. Of these, 25 patients who had a Glasgow Coma Scale (GCS) score no greater 8 and no less than 6 underwent transcranial Doppler (TCD) before decompressive craniectomy, as well as ICP, after removing the skull and suturing the dura mater. The 60 patients were divided into 2 groups according to the following standards (I) GCS score ≥8 on the 7th day postoperatively; (II) ICP continuously lower than 25 mmHg for the entire 7-day duration postoperatively; and (III) brain tissue consistently offset from the skull surface by 5 mm. The clinical outcome was determined based on the Glasgow Outcome Scale (GOS) 1, 3, and 6 months postoperatively. The TCD value, ICP, and prognosis were compared between the 2 groups.
The average postoperative ICP <19 mmHg in the first 24 h, mean blood flow velocity >56.33 cm/s, end-diastolic blood flow velocity >40.28 cm/s, and resistance index <0.57 were statistically significant indicators to predict good prognosis .
The use of TCD can predict the prognosis of severe craniocerebral injury patients.
The use of TCD can predict the prognosis of severe craniocerebral injury patients.
Reduning injection is a traditional Chinese medicine (TCM) with known efficacy against a variety of viral infections, but there is no data about its efficacy against coronavirus disease 2019 (COVID-19).
To explore the efficacy and safety of Reduning injection in the treatment of COVID-19, a randomized, open-labeled, multicenter, controlled trial was conducted from 12 general hospitals between 2020.02.06 and 2020.03.23. Patients with COVID-19 who met the diagnostic criteria of the "Diagnosis and Treatment Program for Novel Coronavirus Infection Pneumonia (Trial Fifth Edition)". Patients were randomized to routine treatment with or without Reduning injection (20 mL/day for 14 days) (ChiCTR2000029589). The primary endpoint was the rate of achieving clinical symptom recovery on day 14 of treatment.
There were 77 and 80 participants in the Reduning and control groups. The symptom resolution rate at 14 days was higher in the Reduning injection than in controls [full-analysis set (FAS) 84.4% vs. 60.0%, P=0.0004]. Compared with controls, the Reduning group showed shorter median time to resolution of the clinical symptoms (143 vs. 313.5 h, P<0.001), shorter to nucleic acid test turning negative (146.5 vs. 255.5 h, P<0.001), shorter hospital stay (14.1 vs. 18.1 days, P<0.001), and shorter time to defervescence (29 vs. 71 h, P<0.001). There was no difference in AEs (3.9% vs. 8.8%, P=0.383).
This preliminary trial suggests that Reduning injection might be effective and safe in patients with symptomatic COVID-19.
This preliminary trial suggests that Reduning injection might be effective and safe in patients with symptomatic COVID-19.
Olanzapine and clozapine are atypical antipsychotics (AAPs) with the greatest risk of weight gain, and changes in feeding behavior are among the most important underlying mechanisms. However, few studies have investigated the role of diet-alone interventions in improving individuals' weight gain by taking AAPs. In closed management mental hospitals of China, family members are allowed to bring food to patients regularly, causing patients to have caloric intake added to their 3 daily meals. However, during the global pandemic of coronavirus disease 2019 (COVID-19), bringing food to the hospital was temporarily prohibited in mental health institutions in China to prevent the spread of the virus. This study sought to compare the body weight and body mass index (BMI) changes of patients taking olanzapine or clozapine undergoing diet-alone interventions caused by this prohibition.
A retrospective self-controlled study was conducted on 90 patients with schizophrenia from a single-center treated with olanzapine orrelation of gender, age, disease course, or equivalent dose with BMI changes was found.
Diet-alone interventions facilitate weight loss in chronically hospitalized schizophrenia patients taking AAPs. Conduction of dietary intervention in the early stages of medication may yield greater benefits.
Diet-alone interventions facilitate weight loss in chronically hospitalized schizophrenia patients taking AAPs. Conduction of dietary intervention in the early stages of medication may yield greater benefits.
Chylothorax is caused by accumulation of chylous fluid in the thoracic cavity following injury to the thoracic duct or its tributaries. It is a rare but relatively severe complication of lung cancer surgery, especially after lung resection and mediastinal lymph node dissection. If chylothorax is not treated promptly and effectively, it may result in relatively high mortality rate. Although the majority of patients with chylothorax secondary to lung cancer surgery can be treated with conservative measures, there are still some patients who fail to respond to conservative treatment or suffer from recurrent episodes. This study aims to explore the causes of postoperative chylothorax and how targeted treatment can help achieve better outcomes.
Four cases of chylothorax secondary to lung cancer surgery are reported in which patients underwent direct lymphangiography (DLG) after failed conservative treatment.
Thoracic duct obstruction was found in all patients on DLG, as well as dilated intrathoracic part of the thoracic duct. Thoracic duct reconstruction was performed to successfully treat 3 of the 4 patients.
DLG is of great value in the diagnosis of chylothorax secondary to lung cancer surgery, for which thoracic duct reconstruction proves to be an effective procedure. DLG provides a new objective basis for the diagnosis and treatment of chylothorax. It is our best wish to help more patients with chylothorax secondary to lung cancer surgery.
DLG is of great value in the diagnosis of chylothorax secondary to lung cancer surgery, for which thoracic duct reconstruction proves to be an effective procedure. DLG provides a new objective basis for the diagnosis and treatment of chylothorax. It is our best wish to help more patients with chylothorax secondary to lung cancer surgery.
Identify the main stressors of the nursing team in assisting patients in oncology palliative care with suspicions and confirmed for COVID-19.
Qualitative, descriptive and exploratory study with theoretical framework in the psychodynamics of work, carried out in the emergency and hospitalization sector of a national reference center for cancer treatment in Rio de Janeiro/Brazil. The semi-structured interview was used to collect the data, from April to May 2020. The data were organized and analyzed using the Collective Subject Discourse (CSD) method with the aid of the Qualiquantisoft® software.
Twenty members of the nursing team participated (10 nurses and 10 nursing technicians). After the analysis, three CSDs with their respective central ideas (CI) emerged. The CSD software, Qualiquantisoft®, also provided a quantitative analysis of the responses, in which 12 (60%) of the respondents believe that the main stressors are associated with work organization, 6 (30%) of the respondents believe that the main stressors are associated to work relationships and 2 (10%) of respondents believe that the main stressors are associated with working conditions.
