Conectar
Surgical site infection (SSI) is one of the common postoperative complications after caesarean section for pregnant women. Previous studies have investigated the risk factors for SSI in pregnant women undergoing caesarean delivery. Whereas big differences in research results exist, and the correlation coefficients of different research results are quite different. A meta-analysis was conducted to examine the risk factors related to SSI in pregnant women undergoing caesarean delivery. We searched English databases to collect case–control studies or cohort studies published between 1 January 2015 and 15 November 2023, including PubMed, Web of Science and ScienceDirect. The risk of bias of the included studies was assessed via Newcastle-Ottawa Scale. The analysis was performed using RevMan 5.4.1 tool. A total of 24 articles (n = 581, 895) were selected in this meta-analysis. The following risk factors were presented to be significantly correlated with SSI in pregnant women following caesarean delivery: smoking (odds ratio [OR] = 1.64, 95% confidence interval [CI] [1.31, 2.04]), previous caesarean section (OR = 1.46, 95% CI [1.18, 1.82]), multiple vaginal examinations (OR = 2.92, 95% CI [1.91, 4.46]), membrane rupture (OR = 1.68, 95% CI [1.19, 2.38]), hypertensive disorders (OR = 1.85, 95% CI [1.33, 2.57]), diabetes mellitus (OR = 1.36, 95% CI [1.18, 1.57]), high body mass index (OR = 1.57, 95% CI [1.35, 1.84]). Occurrence of SSI is influenced by a variety of factors. Thus, we should pay close attention to high-risk subjects and take crucial targeted interventions to lower the SSI risk after caesarean section. Owing to the limited quality and quantity of the included studies, more rigorous studies with adequate sample sizes are needed to verify the conclusion.
To evaluate the impact of usual care plus a fundamental nursing care guideline compared to usual care only for patients in hospital with COVID-19 on patient experience, care quality, functional ability, treatment outcomes, nurses' moral distress, patient health-related quality of life and cost-effectiveness.
Parallel two-arm, cluster-level randomized controlled trial.
Between 18th January and 20th December 2021, we recruited (i) adults aged 18 years and over with COVID-19, excluding those invasively ventilated, admitted for at least three days or nights in UK Hospital Trusts; (ii) nurses caring for them. We randomly assigned hospitals to use a fundamental nursing care guideline and usual care or usual care only. Our patient-reported co-primary outcomes were the Relational Aspects of Care Questionnaire and four scales from the Quality from the Patient Perspective Questionnaire. We undertook intention-to-treat analyses.
We randomized 15 clusters and recruited 581 patient and 418 nurse participants. Primary outcome data were available for 570–572 (98.1%–98.5%) patient participants in 14 clusters. We found no evidence of between-group differences on any patient, nurse or economic outcomes. We found between-group differences over time, in favour of the intervention, for three of our five co-primary outcomes, and a significant interaction on one primary patient outcome for ethnicity (white British vs. other) and allocated group in favour of the intervention for the ‘other’ ethnicity subgroup.
We did not detect an overall difference in patient experience for a fundamental nursing care guideline compared to usual care. We have indications the guideline may have aided sustaining good practice over time and had a more positive impact on non-white British patients' experience of care.
We cannot recommend the wholescale implementation of our guideline into routine nursing practice. Further intervention development, feasibility, pilot and evaluation studies are required.
Fundamental nursing care drives patient experience but is severely impacted in pandemics. Our guideline was not superior to usual care, albeit it may sustain good practice and have a positive impact on non-white British patients' experience of care.
CONSORT and CONSERVE.
Patients with experience of hospitalization with COVID-19 were involved in guideline development and writing, trial management and interpretation of findings.
by Win Lee Edwin Wong, Ryan Arathimos, Cathryn M. Lewis, Allan H. Young, Gavin S. Dawe
The relaxin-3/RXFP3 system has been implicated in the modulation of depressive- and anxiety-like behaviour in the animal literature; however, there is a lack of human studies investigating this signalling system. We seek to bridge this gap by leveraging the large UK Biobank study to retrospectively assess genetic risk variants linked with this neuropeptidergic system. Specifically, we conducted a candidate gene study in the UK Biobank to test for potential associations between a set of functional, candidate single nucleotide polymorphisms (SNPs) pertinent to relaxin-3 signalling, determined using in silico tools, and several outcomes, including depression, atypical depression, anxiety and metabolic syndrome. For each outcome, we used several rigorously defined phenotypes, culminating in subsample sizes ranging from 85,881 to 386,769 participants. Across all outcomes, there were no associations between any candidate SNP and any outcome phenotype, following corrections for multiple testing burden. Regression models comprising several SNPs per relevant candidate gene as exploratory variables further exhibited no prediction of outcome. Our findings corroborate conclusions from previous literature about the limitations of candidate gene approaches, even when based on firm biological hypotheses, in the domain of genetic research for neuropsychiatric disorders.
FreshRSS 