Conectar
by Hongtao Li, Li Xu, Longxin An, Xiaojing Li, Linjing Zhang, Jun Liu, Kaili Zhai, Xuecheng Sun, Naibo Feng
PurposeTo evaluate whether posterior column screws penetrate the posterior cortical surface of the acetabulum when assessed using obturator oblique radiographic imaging.
MethodsComputed tomography (CT) scans were performed on the right acetabulum of 50 healthy adults to measure the angle (α) between the posterior wall of the acetabulum and the sagittal plane at the level of the femoral head’s maximal diameter. In addition, five cadaveric pelvises were subjected to C-arm fluoroscopic imaging. A 6 cm long, 1.5 mm Kirschner wire was positioned along the posterior surface of the acetabular posterior column, aligned with the greater sciatic notch, and imaged in both the 45° and α-degree obturator oblique views. The radiographic line visualized from the Kirschner wire in the obturator oblique view was defined as the posterior iliac line, and its anatomical relationship with the posterior surface of the posterior column was analyzed. Subsequently, a 2.5 mm Kirschner wire was inserted into the posterior column at the standard entry point for screw placement using an electric drill, with the wire tip intentionally positioned between the posterior iliac line and the posterior rim in the 45° obturator oblique view. The trajectory of the wire was assessed under both 45° and α-degree obturator oblique views to determine its relation to the osseous corridor.
ResultsThe measured angle between the posterior surface of the acetabular posterior column and the sagittal plane was (60.2 ± 2.5)°. In the 45° obturator oblique view, the posterior iliac line corresponded with the outer edge of the iliac crest superiorly and the outer edge of the ischium inferiorly, while the posterior wall was projected posterior to the midpoint of the posterior iliac line. In the α° obturator oblique view, the posterior iliac line maintained this alignment but intersected centrally with the posterior acetabular wall. The 2.5 mm Kirschner wire remained within the osseous corridor under the 45° view but potentially extended beyond it under the α° view.
ConclusionWhen the posterior column screw is visualized posterior to the posterior iliac line in the 45° obturator oblique view, further assessment using a α° view is necessary. If the screw appears anterior to the posterior iliac line in the α° view, it indicates that the posterior cortical surface has not been breached.
by Meirong Shan, Qian Guo, Ruofei Li, Ni Li, Yanhua Fu, Huanyu Qi, Ge Zhang, Qian Wang, Xingli Xu, Jinchuan Lai
Hypertension is one of the main causes of cardiovascular diseases worldwide, affecting over one billion people. Although aliskiren offers a valuable option for inhibiting the renin-angiotensin system, its safety profile in the real world remains insufficiently explored, especially for rare or under-recognized adverse events (AEs), which have not been fully clarified. Therefore, leveraging large-scale post-marketing surveillance data is crucial for identifying rare AEs and guiding safer clinical practice. This study aims to elucidate pharmacovigilance signals associated with aliskiren (an antihypertensive drug) by systematically analyzing the characteristics of adverse events (AEs) from the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database and WHO-VigiAccess database, which provides a reliable scientific basis for clinical practice and regulatory decision-making. We conducted a retrospective quantitative analysis of aliskiren-related AE reports from the aforementioned two databases, employing the Proportional Reporting Ratio (PRR), Reporting Odds Ratio (ROR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS) algorithms for signal detection. The results indicate that there were 5,596 and 5,549 aliskiren-related reports in the FAERS and WHO-VigiAccess databases, respectively. The median duration of these AEs during the observation period was 62 days, with an interquartile range (IQR) of 7–282 days. In both databases, signals for aliskiren were distributed across 28 System Organ Classes (SOCs), among which investigations, cardiac disorders, renal and urinary disorders, vascular disorders, and metabolism and nutrition disorders exhibited significant signals based on specific criteria applied across the four algorithms. A total of 607 preferred terms (PTs) with significant disproportionality signals were detected using the four algorithms, including potential AEs not previously well-documented, such as palpitations, myalgia, proteinuria, muscular weakness, pulmonary edema, and pollakiuria. This study not only confirms the known adverse reactions of aliskiren but also uncovers new potential risks, highlighting the importance of strengthening drug safety monitoring to enhance therapeutic efficacy and reduce the risk of adverse reactions. It provides valuable safety insights for physicians considering the use of aliskiren in the management of primary hypertension.To evaluate the effects of the organisational environment on hospital discharge readiness during public health emergencies.
An observational study.
A regression-discontinuity design approach was employed to assess the impact of the organisational environment on hospital discharge readiness. Adult patients diagnosed with acute myocardial infarction and discharged from the Cardiac Critical Care Unit of a tertiary hospital in Shanghai, China, were recruited. Spearman correlation analysis was conducted to examine the associations between multiple factors at individual and organisational levels and hospital discharge readiness across three stages of pandemic policy changes.
A total of 411 patients were included in the analysis. The regression-discontinuity analysis revealed a significant discontinuity at the cut-off, indicating that policy-driven changes in the organisational environment during public health emergencies were associated with a 21.61% reduction in hospital discharge readiness. Additionally, family functioning and the quality of nursing discharge education were significantly associated with discharge readiness across all three pandemic stages.
These findings demonstrate that patient-perceived hospital discharge readiness is significantly influenced by changes in the organisational environment during public health emergencies. Future research should focus on developing targeted discharge preparation programmes that allow for organisational adaptation in response to emergencies, such as pandemics or natural disasters.
Organisational responses to public health emergencies need to prioritise enhancing discharge preparedness. This includes bolstering family involvement and ensuring that nurses are adequately trained to provide effective discharge education, especially when healthcare resources are strained.
The findings underscore the importance of adaptable and resilient discharge planning and transitional care, particularly in public health emergencies. Fostering an organisational environment that supports seamless discharge processes can significantly improve patient readiness for post-hospital care.
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.
No patient or Public Contributions.
Mortal distress encompasses emotional, cognitive, physical and behavioural responses to death and dying among healthcare staff who frequently encounter mortality in hospital settings. Healthcare workers often experience heightened levels of mortal distress due to their regular exposure to patient deaths, which can negatively impact both their personal and professional lives, leading to burnout and high turnover rates.
To identify and quantitatively synthesise correlates of mortal distress among hospital healthcare staff and examine moderating factors affecting these relationships.
Systematic review and meta-analysis following PRISMA 2020 guidelines
Two independent reviewers screened and extracted data from studies published between January 1990 and December 2024 across eight databases (five English: CINAHL, MEDLINE, ProQuest, PubMed, Scopus; three Chinese: Airiti, CNKI, Wanfang). Quality assessment was conducted using the Mixed Methods Appraisal Tool. Meta-analysis was performed using Comprehensive Meta-Analysis 3.0.
Analysis of 94 studies identified three factor domains: personal, job-related and situational. Four job-related factors demonstrated the strongest correlations with mortal distress: competence in coping with death in healthcare contexts, needs for death-related or hospice care training, quality of end-of-life communication, and working in departments with high patient mortality rates. Four significant moderators influenced correlation strength: publication language, geographic region, study quality, and measurement tools used for assessing mortal distress.
This synthesis provides evidence regarding the magnitude and strength of factors associated with mortal distress among healthcare staff. The identification of main and moderator effects emphasises the critical need for developing culturally sensitive, tailored interventions to help healthcare workers navigate mortality-related challenges.
The results can guide healthcare organisations in developing targeted interventions and training programs, inform medical and nursing education curricula by encouraging the inclusion of life and death education, and ultimately enhance staff well-being while improving the quality of patient and family care, especially in palliative care contexts.
This study did not include patient or public involvement in its design, conduct, or reporting.
PROSPERO number: CRD42021275460
FreshRSS 