FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerTus fuentes RSS

Conducting family meetings on families with dementia: An integrative review

Abstract

Aim

To explore the role of family meetings for individuals living with dementia and their family caregivers.

Design

Integrative review.

Methods

We conducted searches in the Cochrane Library, PubMed, CINAHL, and Embase databases (up to December 2022). Additionally, an ancestry search strategy was employed to supplement the retrieval of published literature related to family meetings or family conferences for people with dementia and their family caregivers.

Results

The review integrated 11 articles, comprising seven quantitative studies, two qualitative studies, and two case reports. The findings did not indicate a significant improvement in end-of-life quality for individuals with dementia in the family meetings group compared to those receiving usual care. Limited evidence suggested some improvement in mental health outcomes for family caregivers. Both intervention and control groups incurred high care costs. However, family meetings appeared to delay nursing home placements for individuals with dementia. Two qualitative studies provided insights into the experiences of families and healthcare professionals participating in family meetings, highlighting opportunities and challenges in implementing such meetings. Additionally, two case reports offered specific and illustrative accounts of typical family meetings.

Conclusion

Family meetings can delay nursing home placements for elderly individuals with dementia. Families dealing with dementia perceive family meetings as an opportunity to collaborate with professionals in providing comprehensive care. Further research is needed to explore the effectiveness of family meetings in decision-making for families affected by dementia. Additionally, addressing timing and process coordination issues in family meetings is crucial for optimising their practices among families dealing with dementia.

Relevance to Clinical Practice

In order to make family meetings more accessible to families of individuals with dementia, we offer the following recommendations for future research and practice: Rather than a blanket rejection, the decision regarding the participation of individuals with dementia in family meetings should be based on their specific condition and the needs of their family. Coordination and harmonisation of opinions and perceptions among family members of individuals with dementia can sometimes be complex for healthcare professionals. The involvement of family coordinators may simplify this process. To determine the optimal timing for holding family meetings that can better assist families dealing with dementia, we propose that the right to initiate a meeting be granted to the family. This allows them to convene with healthcare professionals and address their concerns at their convenience.

Effects of rapid rehabilitation nursing on surgical‐site wound infection and postoperative complications of patients undergoing thoracoscopic lung cancer surgery: A meta‐analysis

Abstract

This meta-analysis systematically evaluates the impact of rapid rehabilitation nursing interventions on wound infections and postoperative complications in patients undergoing thoracoscopic lung cancer surgery. A comprehensive literature search was conducted, from database inception to November 2023, using databases including PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases to identify randomized controlled trials (RCTs) that focused on the application of rapid rehabilitation nursing in the perioperative period of thoracoscopic lung cancer surgery. Two researchers independently screened the literature, extracted data, and assessed the quality based on inclusion and exclusion criteria. Data analysis was performed using Stata 17.0 software. A total of 22 RCTs involving 2319 patients were included in the analysis. The results indicated that the application of rapid rehabilitation nursing in thoracoscopic lung cancer surgery significantly reduced the incidence of wound infections (OR = 0.32, 95% CI: 0.20–0.54, p < 0.001) and postoperative complications (OR = 0.24, 95% CI: 0.18–0.31, p < 0.001). This study demonstrates that implementing rapid rehabilitation nursing interventions during the perioperative period for patients undergoing thoracoscopic lung cancer surgery can significantly decrease the occurrence of wound infections and complications, thereby facilitating rapid patient recovery.

Effect of antiplatelet therapy after COVID-19 diagnosis: A systematic review with meta-analysis and trial sequential analysis

by Hong Duo, Mengying Jin, Yanwei Yang, Rewaan Baheti, Yujia Feng, Zirui Fu, Yuyue Jiang, Lanzhuoying Zheng, Jing Wan, Huaqin Pan

Background

Coronavirus disease 2019 (COVID-19) may predispose patients to thrombotic disease in the venous and arterial circulations.

Methods

Based on the current debate on antiplatelet therapy in COVID-19 patients, we performed a systematic review and meta-analysis to investigate the effect of antiplatelet treatments. We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science on February 1, 2023, and only included Randomized clinical trials. The study followed PRISMA guidelines and used Random-effects models to estimate the pooled percentage and its 95% CI.

Results

Five unique eligible studies were included, covering 17,950 patients with COVID-19. The result showed no statistically significant difference in the relative risk of all-cause death in antiplatelet therapy versus non-antiplatelet therapy (RR 0.94, 95% CI, 0.83–1.05, P = 0.26, I2 = 32%). Compared to no antiplatelet therapy, patients who received antiplatelet therapy had a significantly increased relative risk of major bleeding (RR 1.81, 95%CI 1.09–3.00, P = 0.02, I2 = 16%). The sequential analysis suggests that more RCTs are needed to draw more accurate conclusions. This systematic review and meta-analysis revealed that the use of antiplatelet agents exhibited no significant benefit on all-cause death, and the upper bound of the confidence interval on all-cause death (RR 95% CI, 0.83–1.05) suggested that it was unlikely to be a substantiated harm risk associated with this treatment. However, evidence from all RCTs suggested a high risk of major bleeding in antiplatelet agent treatments.

Conclusion

According to the results of our sequential analysis, there is not enough evidence available to support or negate the use of antiplatelet agents in COVID-19 cases. The results of ongoing and future well-designed, large, randomized clinical trials are needed.

Exploration of machine learning models for surgical incision healing assessment based on thermal imaging: A feasibility study

Abstract

In this study, we explored the use of thermal imaging technology combined with computer vision techniques for assessing surgical incision healing. We processed 1189 thermal images, annotated by experts to define incision boundaries and healing statuses. Using these images, we developed a machine learning model based on YOLOV8, which automates the recognition of incision areas, lesion segmentation and healing classification. The dataset was divided into training, testing and validation sets in a 7:2:1 ratio. Our results show high accuracy rates in incision location recognition, lesion segmentation and healing classification, indicating the model's effectiveness as a precise and automated diagnostic tool for surgical incision healing assessment. Conclusively, our thermal image-based machine learning model demonstrates excellent performance in wound assessment, paving the way for its clinical application in intelligent and standardized wound management.

Effect of a multidisciplinary team approach on the management of diabetic foot ulcers on the Central Coast: A review of the Gosford Hospital High‐Risk Foot Clinic

Abstract

This retrospective cohort study aims to assess whether the implementation of a multidisciplinary approach in the Gosford Hospital High-Risk Foot Clinic improved outcomes of diabetic foot ulcers. Ulceration is a common foot complication of diabetes mellitus and greatly increases patient morbidity and mortality. Patients who attended at least one appointment at the Gosford Hospital High-Risk Foot Clinic in 2017 or 2019 were identified through the Gosford Hospital Podiatry department's records. The 2017 and 2019 cohorts were compared on measures of ulcer healing, incidence of amputation, incidence of vascular intervention and surgical debridement, percentage of patients admitted to hospital due to complications and use of systemic antibiotic therapy. Sixty-one patients in 2017 and 59 patients in 2019 met inclusion criteria, and from them, 207 ulcers were included. Between 2017 and 2019, there was a 6.2-week reduction in time to 100% ulcer healing in 2019 (p = 0.021), and 10.1% more ulcers healed within 52 weeks (p = 0.22, 95% confidence interval [CI] [−5.9%, 25.5%]). Whilst there was no significant difference in incidence of patients receiving amputation, there was an increased absolute number of amputations in 2019. Implementation of a multidisciplinary approach at the Gosford Hospital High-Risk Foot Clinic led to improvements in diabetic foot ulcer healing.

Interactions of plumbagin with five common antibiotics against <i>Staphylococcus aureus in vitro</i>

by Songtao Bie, Qiuyue Mo, Chen Shi, Hui Yuan, Chunshuang Li, Tong Wu, Wenlong Li, Heshui Yu

Staphylococcus aureus is the main culprit, causing a variety of severe clinical infections. At the same time, clinics are also facing the severe situation of antibiotic resistance. Therefore, effective strategies to address this problem may include expanding the antimicrobial spectrum by exploring alternative sources of drugs or delaying the development of antibiotic resistance through combination therapy so that existing antibiotics can continue to be used. Plumbagin (PLU) is a phytochemical that exhibits antibacterial activity. In the present study, we investigated the in vitro antibacterial activity of PLU. We selected five antibiotics with different mechanisms and inhibitory activities against S. aureus to explore their interaction with the combination of PLU. The interaction of combinations was evaluated by the Bliss independent model and visualized through response surface analysis. PLU exhibited potent antibacterial activity, with half maximal inhibitory concentration (IC50) and minimum inhibitory concentration (MIC) values against S. aureus of 1.73 μg/mL and 4 μg/mL, respectively. Synergism was observed when PLU was combined with nitrofurantoin (NIT), ciprofloxacin (CPR), mecillinam (MEC), and chloramphenicol (CHL). The indifference of the trimethoprim (TMP)-PLU pairing was demonstrated across the entire dose-response matrix, but significant synergy was observed within a specific dose region. In addition, no antagonistic interactions were indicated. Overall, PLU is not only a promising antimicrobial agent but also has the potential to enhance the growth-inhibitory activity of some antibiotics against S. aureus, and the use of the interaction landscape, along with the dose-response matrix, for analyzing and quantifying combination results represents an improved approach to comprehending antibacterial combinations.

Developing an early warning system for detecting sepsis in patients with trauma

Abstract

The purpose of this study was to analyse the risk factors for sepsis in patients with trauma and develop a new scoring system for predicting sepsis in patients with trauma based on these risk factors. This will provide a simple and effective early warning method for the rapid and accurate detection and evaluation of the probability of sepsis in patients with trauma to assist in planning timely clinical interventions. We undertook a retrospective analysis of the clinical data of 216 patients with trauma who were admitted to the emergency intensive care unit of the emergency medicine department of the Hebei Medical University Third Hospital, China, between November 2017 and October 2022. We conducted a preliminary screening of the relevant factors using univariate logistic regression analysis and included those factors with a p value of <0.075 in the multivariate logistic regression analysis, from which the risk factors were screened and assigned, and obtained a total score, which was the sepsis early warning score. The incidence of sepsis in patients in the intensive care unit with trauma was 36.9%, and the mortality rate due to sepsis was 19.4%. We found statistically significant differences in several factors for patients with sepsis. The risk factors for sepsis in patients with trauma were the activated partial thromboplastin time, the New Injury Severity Score, growth differentiation factor-15 levels, shock, mechanical ventilation and the Acute Physiology and Chronic Health Evaluation II score. The area under the receiver operating characteristic curve of the sepsis early warning score for predicting sepsis in patients with trauma was 0.725. When the cutoff value of the early warning score was set at 5.0 points, the sensitivity was 69.9% and the specificity was 60.3%. The incidence of sepsis in patients with trauma can be reduced by closely monitoring patients' hemodynamics, implementing adequate fluid resuscitation promptly and by early removal of the catheter to minimize the duration of unnecessary invasive mechanical ventilation. In this study, we found that the use of the sepsis early warning score helped in a more accurate and effective evaluation of the prognosis of patients with trauma.

Oral frailty: A concept analysis

Abstract

Aim

To clarify the concept of oral frailty to provide a clear and standardized conceptual basis for further research in older people.

Design

Rodgers and Knafl's evolutionary concept analysis approach.

Methods

The narrative analysis detailedly extracted and synthesized the attributes of oral frailty, as well as its antecedents, consequences and related terms under the guidance of Rodgers' evolutionary method.

Data Sources

Multiple databases including Pubmed, CINAHL and Cochrane were searched using selected search terms ‘oral frail*’, ‘oral health’ and ‘aged’ respectively. Articles written between 2013 and 2023 were included, and grey literature was excluded.

Results

A total of 32 articles were included for further analysis and synthesis. The attributes of oral frailty were hypofunction, predisposing in nature, non-specific and multidimensional. Antecedents of prefrailty were classified into four categories, namely, sociodemographic characteristics, comorbidity, physical function and psychosocial factors. Consequences of oral frailty include three themes: increased risk of adverse outcomes, poor nutritional status and possibility of social withdrawal. Related terms that had shared attributes with oral frailty were oral health, functional dentition, oral hypofunction and deterioration of oral function.

Conclusions

Oral frailty is an age-related phenomenon reflected in decreased oral function. The findings of this concept analysis are conducive to understanding and clarifying the oral frailty, which can help clinicians or other healthcare providers to consider how to distinguish oral frailty in older adults and further promote the development of this field.

Impact

Oral frailty is increasingly recognized as an age-related phenomenon reflected in decreased oral function. As it is newly proposed, no consensus has been reached regarding the theoretical and operational concept of it. Through clarifying the concept, this paper will guide future healthcare research on oral frailty regarding the influencing factors, mechanisms and interventions, thus raising the awareness with regard to oral health among older adults.

What does this paper contribute to the wider global clinical community?

In the context of older adults, oral frailty is a concept that requires further research to guide future theoretical development, and the influencing factors, mechanisms and interventions need to be further studied. Raise awareness with regard to oral health among older people and more attention will be paid to the early identification and intervention of oral frailty, so as to further improve the quality of life of older adults.

Assessing the impact of digital transformation on capital market information efficiency under environmental uncertainty: Evidence from China

by Tao Feng, Xiaohuan Dong, Yueyun Wang

Digital transformation is an emerging development opportunity for enterprises in the digital economy and comprehensively reflects the application of digital technology to production, operation, and management strategies. This study used data on A-share listed enterprises in Shanghai and Shenzhen from 2007 to 2022 to examine the relationship between the digital transformation of enterprises and information efficiency of the capital market. Findings revealed that digital transformation can improve the information efficiency of the capital market and that environmental uncertainty plays a more significant regulatory role. The greater the environmental uncertainty, the more enterprises with a high degree of digital transformation can promote the information efficiency of the capital market. Additional analysis showed that the promotional effect of digital transformation on the information efficiency of the capital market is better for non-state-owned enterprises and small and medium-sized enterprises. This study provides detailed insights into digital transformation and capital market information efficiency, which enriches the research related to the economic consequences of digital transformation and demonstrates the theoretical and practical value of corporate digital transformation.

Effect of suture closure and staple closure on postoperative wound complications in patients undergoing knee replacement surgery: A meta‐analysis

Abstract

The purpose of this meta-analysis is to determine if the application of stitching in the closed area of the knee arthroplasty remains significantly superior to that of the staples. Data sources: EMBASE, Cochrane Libraryand, publications, and the Web of Science. Patients were treated with staples for closure of their wounds, or with conventional stitches for closure of wounds. The main findings were surgical site infection, wound dehiscence, and cutting time. The secondary results were the time to completion, the duration of the hospitalization, and the time to discharge. We incorporated the SIX trial into the meta-analyses with Review Manager V.5.3. The hazard ratio was computed as a therapeutic outcome with respect to the heterogeneity. For more than 50% of heterogeneous samples, we employed a stochastic effect model. The results showed that there was no significant difference in the degree of infection, the degree of dehiscence, the length of the cut and the degree of satisfaction of the wound. But the time to close the wound and the time to operate were significantly different. The time needed to close the wound was shorter than that of the suture (OR, −227. 22; 95% CI, −238. 74, −215. 69 p < 0. 0001); The time taken to replace the knee was also significantly lower among those who had been stapled sutures (OR, −5.46; 95% CI, −10. 43, −0.49 p = 0. 03). Wound closing materials are an afterthought for many orthopaedic surgeons. Together, the findings from a number of comparative studies indicate that the selection of wound closure materials might affect the outcome of the surgery. The evidence, however, is weak because of the heterogeneous approach adopted in earlier research. This study program is intended to provide guidance on how to select the best wound closure material for the purpose of identifying if there is any difference in the incidence of injuries among traditional stitches and staples.

Triglyceride‐glucose index is strongly associated with all‐cause mortality in elderly females with diabetic foot ulcers: A 9‐year follow‐up study

Abstract

This study aims to explore the association between the triglyceride-glucose (TyG) index and all-cause mortality in patients with diabetic foot ulcers (DFUs) through an ambispective cohort study. A total of 555 inpatients with DFUs were qualified to participate in the trial study from 2013 to 2022. Throughout a median 63-month period, all subjects were followed up every 6 months. According to the three quantiles of the TyG index, participants were divided into three groups: low-level (≤8.75, n = 185), moderate-level (8.76–9.33, n = 185) and high-level (≥9.34, n = 185). The association between the TyG index and all-cause mortality in patients with DFUs was then assessed. During the follow-up period, out of 555 patients with DFUs, 116 died (20.9%). After adjusting for confounding factors, the TyG index was positively associated with all-cause mortality in patients with DFUs (HR = 1.733; 95% CI = 1.341–2.241; p < 0.001). Compared with the low-level TyG index, the moderate-level TyG index (HR = 1.685; 95% CI = 1.011–2.810; p = 0.045) and the high-level TyG index (HR = 2.769; 95% CI = 1.678–4.568; p < 0.001) were positively correlated with all-cause mortality in patients with DFUs. Additionally, in subgroup analysis, both females (HR = 1.905; 95% CI = 1.250–2.904; p = 0.003), males (HR = 1.729; 95% CI = 1.240–2.409; p = 0.001), younger (<65 years old) (HR = 1.467; 95% CI = 1.008–2.135; p = 0.046) and elderly (≥ 65) (HR = 1.933; 95% CI = 1.339–2.791; p < 0.001) showed a positive correlation between TyG index and all-cause mortality rate in patients with DFUs. Furthermore, in the high-level TyG index group compared, males (HR = 2.699; 95% CI = 1.457–4.998) and participants aged <65 years (HR = 2.031; 95% CI = 0.972–4.242), with the TyG index level increase by 1.0, the risk for all-cause mortality increased 3.277-fold in females (HR = 4.277; 95% CI = 1.645–11.124) and 1.909-fold in elderly aged ≥65 years (HR = 2.909; 95% CI = 1.486–5.695), respectively. Kaplan–Meier survival curve analysis showed that the higher the TyG index level, the higher risk of all-cause mortality in patients with DFUs (log-rank, all p < 0.001). Briefly, this study implies a strong positive correlation between the TyG index and all-cause mortality in patients with DFUs, especially in older women. Therefore, special attention should be paid to elderly females with DFUs because they have a higher TyG index level and risk of all-cause mortality than other populations in daily clinical practice.

Assessing the impact of diverse mask types on COPD patients: a randomised controlled trial study protocol

Por: Chen · X. · Jiang · X. · Zhang · X. · Ren · D. · Wei · C. · Xu · A. · Yang · H. · Bai · R. · Li · C. · Yue · F. · Bao · S. · Shi · J. · Fan · J.
Introduction

Wearing masks has proven beneficial in preventing respiratory pathogen infections in individuals with chronic obstructive pulmonary disease (COPD). However, the impact of different mask types on physiological indicators and daily physical activity in COPD patients remains uncertain. This study aims to assess the immediate effects of various mask types on cardiopulmonary function indicators, subjective perceptions and the 6-minute walking distance (6MWD) in individuals with COPD.

Methods and analysis

This randomised controlled trial will enrol 129 stable COPD patients. Participants will be randomly divided into three groups: control, N95 mask and surgical mask groups. Each group will undergo both a 6-minute seated test and a 6-minute walk test (6MWT), without or with their respective masks. A 10-minute interval will be provided between the two phases. The primary indicators of the study include the 6MWD and blood oxygen saturation. Secondary outcomes encompass blood pressure, pulse rate, Borg score, Rate of Perceived Exertion (RPE) score and subjective perception score. Oxygen saturation, pulse rate and blood pressure will be recorded four times during the trial, while Borg and RPE scores will be compared before and after the 6MWT. Additionally, subjective perception scores will be collected after each mask-wearing stage.

Ethics and dissemination

This study has received approval from the Ethics Committee of the Affiliated Hospital of Gansu University of Chinese Medicine (approval number: 202335). We plan to disseminate research results through publication in a peer-reviewed journal or presentation at a conference.

Trial registration number

ChiCTR2300074554.

Association between the triglyceride glucose index and low skeletal muscle mass: a cross-sectional study

Por: Li · Z. · Tong · X. · Ma · Y. · Bao · T. · Yue · J.
Objectives

Triglyceride glucose (TyG) represents a consistent surrogate biomarker and index of insulin resistance (IR), IR has also been linked to skeletal muscle mass loss (SMM-L). Here, we evaluated the association between SMM-L and the TyG index (TyGi).

Design

An analytical cross-sectional study.

Setting

Tertiary care hospitals.

Participants

36 275 participants who underwent health checks between 1 January 2013 and 31 December 2020.

Primary and secondary outcome measures

A bioelectrical impedance analysis was used to assess the body composition, SMM-L was defined as low ASMI (total limb lean mass/height2) and TyGi was calculated as ln(triglycerides (mg/dL)xfasting blood glucose (mg/dL)/2).

Results

A total of 36 275 subjects were included in the study, of which 58.46% were male, with a mean age of 43.74±12.33 years. The prevalence of low skeletal muscle mass (SMM) was 17.7% and the mean TyGi was 8.56±0.64. TyGi was found to be significantly correlated with low SMM in all subjects (OR 1.87, 95% CI 1.75 to 2.00, p

Conclusions

These data demonstrated a significant independent interaction between TyGi and low SMM in all subjects regardless of sex and age subgroups in the general population.

Comparative study of wound outcomes and surgical strategies: Internal fixation versus external stabilization in rib fracture patients with traumatic chest wounds

Abstract

The clinical management of traumatic chest incisions accompanied by rib fractures presents the formidable challenge. The study was carried out to compare the outcomes of auscultatory triangle internal fixation (ATIF) and external fixation (EF) in such injuries. From June 2019 to June 2022, 105 patients with multiple rib fractures participated in the cohort study in which they were divided into two groups: 53 patients underwent ATIF and 52 patients underwent EF. The incidence of surgical site infection, wound healing time, incidence of wound dehiscence, number of dressing changes, pain as measured by the visual analogue scale (VAS), duration of hospitalization, period of return to work, pulmonary complications and functionality of the upper limbs as assessed by the Disability of Arm, Shoulder, and Hand (DASH) questionnaire were among the parameters evaluated. In comparison with EF, ATIF demonstrated the decreased incidence of wound dehiscence (1.9% vs. 9.6%) (p < 0.05), surgical site infection (3.8 vs. 11.5) and wound healing time (12.3 ± 2.1 vs. 18.5 ± 3.7 days) (p < 0.05). Furthermore, during their ATIF treatment, patients required fewer changes of dressing (3.5 ± 0.8 vs. 5.7 ± 1.2) and demonstrated enhanced pain management, reduced hospital stays and expedited return to work (p < 0.05). ATIF group demonstrated enhancements in both upper limb functionality and post-operative pulmonary function (p < 0.05). The utilization of ATIF as opposed to EF for the treatment of traumatic chest wounds accompanied by rib fractures yields superior outcomes in terms of wound healing, infection reduction and restoration of pulmonary and upper limb functionality.

Influencing factors of falls among older adults in Chinese retirement institutions: A systematic review and meta-analysis

by Xiaoxing Huang, Yunlan Jiang, Yaxin Liu, Liyin Shen, Jing Pan, Yue Zhang

Background

The incidence of falling has always been high among the elderly, and it was easy to cause injuries to the elderly and seriously affect their quality of life. There were many studies have been conducted on risk factors affecting the fall of the elderly, but the results widely, retirement institutions as a gathering place for the elderly, there was currently no comprehensive analysis of the factors related to elderly falls in pension institutions. This study aimed to explore the influencing factors of falls among older adults in Chinese nursing homes.

Methods

Chinese and English databases were searched for literature published from database inception to 5 April 2023 on the influencing factors of falls among older adults in Chinese nursing homes. Two reviewers independently screened articles, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using RevMan 5.4 software.

Results

Eleven studies involving 3503 participants were included in the meta-analysis. The pooled estimate of falls among older adults in Chinese nursing homes was 32% [95% confidence interval (95%CI) (24.0%, 39.0%)]. The main influencing factors for falls among older adults in Chinese nursing homes were age (Odds Ratio (OR) = 1.53), gender (OR = 5.50), visual impairment (OR = 2.30), sedative-hypnotics (OR = 2.36), fear of falling (OR = 2.95), hypertension (OR = 3.72), static balance (OR = 2.02), three or more chronic diseases (OR = 5.63), cognitive status (OR = 2.64), walking aid use (OR = 1.98), fall-related chronic diseases (OR = 2.48), self-awareness of abilities (OR = 2.43), and frequent reminders for fall prevention (OR = 0.10).

Conclusion

Falls among older adults in Chinese nursing homes were common, and there were many influencing factors. Timely screening and intervention should be implemented to reduce the adverse consequences of falls on older adults.

Trial registration

Registration number: CRD42023421099.

Anesthesia-related intervention for long-term survival and cancer recurrence following breast cancer surgery: A systematic review of prospective studies

by Yuecheng Yang, Yunkui Zhang, Yonghong Tang, Jun Zhang

Objective

Anesthesia is correlated with the prognosis of cancer surgery. However, evidence from prospective studies focusing on breast cancer is currently limited. This systematic review aimed to investigate the effect of anesthesia-related interventions on oncological outcomes following breast cancer surgery in prospective studies.

Methods

Literature searches were performed from inception to June. 2023 in the Pubmed, Web of Science, Embase, and ClinicalTrials databases. The main inclusion criteria comprised a minimum of one-year follow-up duration, with oncological outcomes as endpoints. Anesthesia-related interventions encompassed, but were not limited to, type of anesthesia, anesthetics, and analgesics. The risk of bias was assessed using the Cochrane Risk of Bias Tool.

Results

A total of 9 studies were included. Anesthesia-related interventions included paravertebral nerve block (3), pectoral nerve block (1), sevoflurane (2), ketorolac (2), and infiltration of lidocaine (1). Cancer recurrence, metastasis, disease-free survival, or (and) overall survival were assessed. Among all included studies, only infiltration of lidocaine was found to prolong disease-free survival and overall survival.

Conclusion

Regional anesthesia and propofol did not improve oncological outcomes following breast cancer surgery. The anti-tumorigenic effect of ketorolac warrants future studies with larger sample sizes. Perioperative infiltration of lidocaine around the tumor may be a promising anti-tumorigenic intervention that can prolong overall survival in patients with early breast cancer.

Impact of preoperative chemotherapy on cutaneous wound healing in lung cancer patients: A meta‐analysis

Abstract

As part of their treatment, lung cancer patients frequently endure thoracic oncological surgery, with preoperative chemotherapeutic interventions being the common approach. However, the potential impact of these chemotherapeutic regimens on cutaneous wound healing outcomes following surgery remains the topic of considerable clinical interest. This meta-analysis sought to evaluate comprehensively the effect of preoperative chemotherapeutic regimens on cutaneous wound healing in lung cancer patients following thoracic oncological surgery. Extensive literature searches were conducted using the leading databases PubMed, Embase, Cochrane Library and Scopus. Eight studies out of 1342 identified satisfied the inclusion criteria. Consideration was given to both randomized controlled trials (RCTs) and observational studies. Data pertaining to study characteristics, patient demographics, chemotherapeutic regimens and wound healing outcomes were extracted with great attention to detail. The examination of these varied studies provided insights into the fluctuations in rates of recovery following treatment, incidences of wound infections and frequencies of surgical complications. The research studies provided odds ratios for recovery that varied significantly in magnitude from 0.95 to 0.38, with regard to the probability of wound infection. Furthermore, a range of odds ratios for complications were disclosed, with certain odds ratios displaying narrow confidence intervals. The complexity of the effect of preoperative chemotherapy on wound closure subsequent to thoracic oncologic surgery is highlighted by our findings. The results underscore the need for individualized treatment strategies for lung cancer patients undergoing surgical procedures that strike a balance between patient safety and optimal clinical outcomes.

Effects of high-intensity functional training on physical fitness and sport-specific performance among the athletes: A systematic review with meta-analysis

by Xinzhi Wang, Kim Geok Soh, Shamsulariffin Samsudin, Nuannuan Deng, Xutao Liu, Yue Zhao, Saddam Akbar

Objective

This study aims to meta-analyze the impact of high-intensity functional training on athletes’ physical fitness and sport-specific performance.

Methods

A systematic search was conducted in five well-known academic databases (PubMed, Scopus, Web of Science, EBSCOhost, and the Cochrane Library) up to July 1, 2023. The literature screening criteria included: (1) studies involving healthy athletes, (2) a HIFT program, (3) an assessment of outcomes related to athletes’ physical fitness or sport-specific performance, and (4) the inclusion of randomized controlled trials. The Physical Therapy Evidence Database (PEDro) scale was used to evaluate the quality of studies included in the meta-analysis.

Results

13 medium- and high-quality studies met the inclusion criteria for the systematic review, involving 478 athletes aged between 10 and 24.5 years. The training showed a small to large effect size (ES = 0.414–3.351; all p Conclusion

High-intensity functional training effectively improves athletes’ muscle strength, power, flexibility, and sport-specific performance but has no significant impact on endurance and agility. Future research is needed to explore the impact of high-intensity functional training on athletes’ speed, balance, and technical and tactical performance parameters.

The incidence and risk factors of unplanned removal of peripherally inserted central catheters among adult patients: A multi‐centre cohort study

Abstract

Aims and Objectives

(i) To estimate the national incidence of unplanned removal of peripherally inserted central catheters (PICCs) in China. (ii) To explore the associated risk factors to provide evidence for the prevention.

Design

A multi-centre prospective cohort study.

Methods

A representative sample of 3222 Chinese adult patients with successful PICC insertion was recruited for the PICC Safety Management Research (PATH) using a two-stage cluster sampling method from December 2020 to June 2022. Sixty hospitals from seven Chinese provinces representing all geographical regions were selected. Demographic information and PICC characteristics were collected using a standard online case report form. Risk factors for the unplanned removal of PICCs were assessed using a cause-specific hazard model and verified using a sub-distribution hazard model. STROBE guidelines were followed in reporting this study.

Results

Three thousand one hundred and sixty-six patients were included in the final analysis with a mean age of 59 years and a total of 344,247 catheter days. The incidence of unplanned removal was 10.04%. Female, with thrombosis history, PICC insertion due to infusion failure, valved catheter and double-lumen catheter were risk factors, whereas longer insertion and exposure length were protective factors in the cause-specific hazard model. Higher BMI became an independent risk factor in the sub-distribution hazard model.

Conclusions

Unplanned removal of PICCs is a serious clinical challenge in China. Our findings call for prevention strategies targeting the identified risk factors.

Relevance to Clinical Practice

Our study characterised the epidemiology of unplanned removal of PICCs among Chinese adult inpatients, highlighting the need for prevention among this population and providing a basis for the formulation of relevant prevention strategies.

Patient or Public Contribution

Patients contributed through sharing their information required for the case report form. Healthcare professionals who provide direct care to the patient at each medical centre contributed by completing the online case report form.

Association between burnout and post‐traumatic stress disorder among frontline nurse during COVID‐19 pandemic: A moderated mediation analysis

Abstract

Aims and Objectives

The aim of this study was to investigate the relationship between burnout and post-traumatic stress disorder (PTSD) among frontline nurses who went to assist the epidemic situation in Wuhan, China, during the outbreak in 2020. The study also explored the mediating role of depression and the moderating role of age in the main relationship.

Background

The relationship between burnout and PTSD in nurse has rarely been investigated in the context of the COVID-19 pandemic. Understand the relationship between these variables can provide empirical evidence for developing interventions and protocols that improve the health of nurses in future public health emergencies.

Design

An online cross-sectional survey of targeted local 327 nurses who went to assist the COVID-19 epidemic situation in Wuhan during the initial outbreak.

Methods

This study was conducted in August 2020, the burnout scale, the PTSD scale and the depression scale were used to survey participants. The moderated mediation model was used to test research hypotheses.

Results

Burnout could affect the PTSD symptoms in nursing staffs and depression could mediate this relationship. Age moderated the relationship between burnout/depression and PTSD, and the effects was strong and significant among younger participants in the relationship between burnout and PTSD.

Conclusions

Burnout was identified as a core risk factor of PTSD in nurses. Depression and age played significant roles in the relationship between burnout and PTSD.

Relevance to Clinical Practice

PTSD, as a symptom that manifests after experiencing a stressful event, should be a key concern among frontline healthcare professionals. This study suggests that PTSD in nurses can be further reduced by reducing burnout. Attention should also be paid to the PTSD status of nurses of different age groups.

Patient or Public Contribution

Patients and the public were not involved in the design and implementation of this study. Frontline nurses completed an online questionnaire for this study.

❌