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Ayer — Mayo 14th 2024Tus fuentes RSS

Duration and severity of COVID‐19 symptoms among primary healthcare workers: A cross‐sectional survey

Abstract

Aims

This study aims to investigate the epidemiological characteristics of COVID-19 infection among healthcare workers, including the severity, duration of infection, post-infection symptoms and related influencing factors.

Methods

A self-administered questionnaire was utilized to assess the post-infection status of primary healthcare workers in Jiangsu Province. The questionnaire collected information on demographic characteristics, lifestyle habits, post-infection clinical manifestations, work environment and recovery time of the respondents. Customized outcome events were selected as dependent variables and logistic regression models were employed to analyse the risk factors. Phi-coefficient was used to describe the relationship between post-infection symptoms.

Results

The analysis revealed that several factors, such as female, older age, obesity, previous medical history, exposure to high-risk environments and stress, were associated with a higher likelihood of experiencing more severe outcomes. On the other hand, vaccination and regular exercise were found to contribute to an earlier resolution of the infection. Among the post-infection symptoms, cough, malaise and muscle aches were the most frequently reported. Overall, there was a weak association among symptoms persisting beyond 14 days, with only cough and malaise, malaise and dizziness and headache showing a stronger correlation.

Conclusion

The study findings indicate that the overall severity of the first wave of infection, following the complete lifting of restrictions in China, was low. The impact on primary healthcare workers was limited, and the post-infection symptoms exhibited similarity to those observed in other countries. It is important to highlight that these conclusions are specifically relevant to the population infected with the Omicron variant.

Impacts

This study helps to grasp the impacts of the first wave of COVID-19 infections on healthcare workers in China after the national lockdown was lifted.

Patients

Primary healthcare workers in Jiangsu Province, including doctors, nurses, pharmacists and other personnel from primary healthcare units such as community health service centres and health centres.

Combining antibiotic‐loaded bone cement‐based free vastus lateralis muscle‐sparing flap with split‐thickness skin grafts: A reliable strategy for reconstructing diabetic foot ulcers at non‐weight‐bearing areas

Abstract

Diabetic foot ulcers (DFUs) present significant challenges due to their associated amputation rates, mortality, treatment complexity and excessive costs. Our earlier work introduced a wound surgical integrated treatment (WSIT) for DFUs, yielding promising outcomes. This study focuses on a specific WSIT protocol employing antibiotic-loaded bone cement (ALBC) in the first Stage, and free vastus lateralis muscle-sparing (VLMS) flaps and split-thickness skin grafts (STSGs) in the second stage to repair non-weight-bearing DFUs. From July 2021 to July 2023, seven DFU patients (aged 47–71 years) underwent this treatment. Demographic data, hospital stay and repair surgery times were collected. Histological and immunohistochemical analyses assessed angiogenesis, collagen deposition and inflammation. SF-36 questionnaire measured pre- and postoperative quality of life. Preoperative ultrasound Doppler showed that the peak blood flow velocity of the recipient area artery was significantly >30 cm/s (38.6 ± 6.8 cm/s) in all patients. Muscle flap sizes varied from 8 × 3.5 × 1 to 18 × 6 × 2 cm. The operation time of the repair surgery was 156.9 ± 15.08 minutes, and the hospital stay was 18.9 ± 3.3 days. Histological analysis proved that covering DFUs with ALBC induced membrane formation and increased collagen, neovascularization and M2 macrophages fraction while reducing M1 macrophages one. All grafts survived without amputation during a 7- to 24-month follow-up, during which SF-36 scores significantly improved. A combination of ALBC with free VLMS flaps and STSGs proved to be safe and effective for reconstructing non-weight-bearing DFUs. It rapidly controlled infection, enhanced life quality and foot function, and reduced hospitalization time. We advocate integrating this strategy into DFU treatment plans.

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Effects of quality nursing on the surgical site wound infection after colostomy in patients with colorectal cancer: A meta‐analysis

Abstract

To systematically evaluate the effects of quality nursing interventions on surgical site wound infections (SSWI), length of stay in the hospital and postoperative complications in patients with colorectal stomas. A search was conducted on Embase, PubMed, Cochrane Library, Web of Science, Wanfang and China National Knowledge Infrastructure databases to retrieve publicly available data from the construction of the database until September 2023 in randomised controlled trials (RCTs) evaluating the effects of applying quality nursing in patients with colorectal cancer (CRC) stoma surgery. Two authors independently performed literature screening, data extraction and quality assessment. Stata 17.0 was applied for our meta-analysis. Fifteen RCTs with 1186 patients, with 593 patients in each of the quality nursing and control groups, were included. Meta-analysis revealed that compared with the control group, the incidence of SSWI (odds ratio [OR] = 0.34, 95% confidence intervals [CI]: 0.21–0.54, p < 0.001) and postoperative complications (OR = 0.2, 95% CI: 0.16–0.30, p < 0.001) in the quality nursing group were significantly reduced, and the length of stay in the hospital was significantly shorter (standardised mean difference = −1.12, 95% CI: −1.42 to −0.82, p < 0.001). The application of quality nursing interventions after CRC stoma surgery is effective in reducing the incidence of SSWI and postoperative complications and can also shorten hospital stays.

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.

Associations of serum DNA methylation levels of chemokine signaling pathway genes with mild cognitive impairment (MCI) and Alzheimer’s disease (AD)

by Ting Zou, Xiaohui Zhou, Qinwen Wang, Yongjie Zhao, Meisheng Zhu, Lei Zhang, Wei Chen, Pari Abuliz, Haijun Miao, Keyimu Kabinur, Kader Alimu

Objective

To investigate the associations of serum DNA methylation levels of chemokine signaling pathway genes with Alzheimer’s disease (AD) and mild cognitive impairment (MCI) in elderly people in Xinjiang, China, and to screen out genes whose DNA methylation could distinguish AD and MCI.

Materials and methods

37 AD, 40 MCI and 80 controls were included in the present study. DNA methylation assay was done using quantitative methylation-specific polymerase chain reaction (qMSP). Genotyping was done using Sanger sequencing.

Results

DNA methylation levels of ADCY2, MAP2K1 and AKT1 were significantly different among AD, MCI and controls. In the comparisons of each two groups, AKT1 and MAP2K1’s methylation was both significantly different between AD and MCI (p MAP2K1’s methylation was also significantly different between MCI and controls. Therefore, AKT1’s methylation was considered as the candidate serum marker to distinguish AD from MCI, and its association with AD was independent of APOE ε4 allele (p AKT1 hypermethylation was an independent risk factor for AD and MAP2K1 hypomethylation was an independent risk factor for MCI in logistic regression analysis (p Conclusion

This study found that the serum of AKT1 hypermethylation is related to AD independently of APOE ε4, which was differentially expressed in the Entorhinal Cortex of the brain and was an independent risk factor for AD. It could be used as one of the candidate serum markers to distinguish AD and MCI. Serum of MAP2K1 hypomethylation is an independent risk factor for MCI.

Is two-point method a valid and reliable method to predict 1RM? A systematic review

by Zongwei Chen, Zheng Gong, Liwen Pan, Xiuli Zhang

This systematic review aimed to evaluate the reliability and validity of the two-point method in predicting 1RM compared to the direct method, as well as analyze the factors influencing its accuracy. A comprehensive search of PubMed, Web of Science, Scopus, and SPORTDiscus databases was conducted. Out of the 88 initially identified studies, 16 were selected for full review, and their outcome measures were analyzed. The findings of this review indicated that the two-point method slightly overestimated 1RM (effect size = 0.203 [95%CI: 0.132, 0.275]; P
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