Conectar
by Qinghua Wen, Xiaoyue Wang, Simin Li, Huanhuan Zhu, Fengyin Zhang, Chao Xue, Juan Li
BackgroundThe glucose disposal rate (eGDR) and a body shape index (ABSI) are predictors strongly associated with cardiovascular disease (CVD) and outcomes. However, whether they have additive effects on CVD risk is unknown. This study aimed to investigate whether combined assessment of eGDR and ABSI could improve prediction of CVD risk.
MethodsThe current study used data from NHANES from 1999 to 2018 and included 14,237 participants. Receiver operating characteristic (ROC) curve was used to evaluate the performance of each indicator in predicting CVD. Machine-learning algorithms were applied to screen variables to adjust the model. Finally, the ROC curve, net reclassification improvement (NRI), integrated discrimination improvement (IDI), calibration curve and decision curve analysis (DCA) were used to evaluate the predictive performance of the combination of eGDR and ABSI.
ResultsThe ROC curve showed that eGDR (C-statistics: 0.7255) and ABSI (0.7093) had the highest predictive performance. Among 14,237 participants, multivariate logistic regression showed that lower eGDR (≤6.448) and higher ABSI (≥0.086) significantly increased CVD risk (OR = 11.792, P Conclusion
The eGDR and ABSI have potential additive effects on predicting CVD risk, and have excellent predictive performance, which can evaluate cardiovascular risk more comprehensively.
Good foot care knowledge and behaviour are very important to prevent the occurrence of diabetic foot, but there are few reports on the foot care knowledge and behaviour of older people with diabetes in the community. The purpose of this study was to understand the foot care knowledge and behaviour of older people with type 2 diabetes in Beijing community, and analyse its influencing factors, so as to provide reference for further intervention. We investigated 254 older people with type 2 diabetes in Xinjiekou community, Beijing, including their general information, chronic complications, foot care knowledge and behaviour. The results showed that the average scores of foot care knowledge and behaviour were 73.38 ± 12.25 and 49.70 ± 8.70, respectively. Multiple stepwise regression analysis showed that the factors affecting the total score of foot nursing knowledge of older people with diabetes in community were gender, duration of diabetes and whether they had received foot nursing education (p < 0.05). The factors influencing the total score of foot nursing behaviour were gender, duration of disease, whether they had received foot nursing education and peripheral vascular disease (p < 0.05). In conclusion, the knowledge of foot care of older people with diabetes in community is in the middle level, and the foot care behaviour is not optimistic. Community healthcare workers can improve patients' knowledge of foot care and improve their compliance with foot care behaviour through foot care health education. At the same time, we should pay more attention to men, those with a shorter duration of diabetes and diabetic patients with peripheral vascular disease to reduce the occurrence of diabetic foot.
A meta-analysis was executed to comprehensively examine the impacts of enhanced recovery after surgery (ERAS) care interventions on complications and wound infections following bladder cancer (BCa) surgery. Computer searches were carried out in Embase, Google Scholar, Cochrane Library, PubMed, Wanfang and CNKI, from their inception to November 2023, for RCTs regarding perioperative ERAS nursing interventions in patients with BCa. Two independent researchers performed literature screening, extracted data and carried out quality evaluations. Stata 17.0 software was utilized for the analysis of the data. Ultimately, 16 RCTs, involving 1190 patients, were included. The analysis showed that, in comparison with conventional nursing methods, perioperative ERAS nursing application in patients with BCa remarkably decreased the occurrence of wound infections (OR: 0.31, 95% CI: 0.16–0.59) and complications (OR: 0.19, 95% CI: 0.13–0.28). Our study indicates that perioperative care based on the ERAS concept remarkably decreased the occurrence of wound infections and complications following BCa surgery, demonstrating notable nursing efficacy and meriting widespread clinical promotion.
We investigated the contamination of the operator and the surrounding environment during wound debridement through simulated operations using fluorescent labelling. On-site simulated operation assessment was performed before and after the training. Oranges and square towels were used to simulate wounds and the inpatient units, respectively. Fluorescent powder was applied to the surfaces. Operations on oranges simulated bedside debridement, and the postoperative distribution of the fluorescent powder was employed to reflect the contamination of the operator and the surrounding environment. During the pre-training assessment, contamination was observed in 28 of the 29 trainees. The commonly contaminated parts were the extensor side of the forearm, middle abdomen, upper abdomen, and hands. The right side of the operating area was contaminated in 24 trainees. During the post-training assessment, contamination was observed in 13 of the 15 trainees. The commonly parts were the hands, extensor side of the forearm, and the lower abdomen. The front, back, left, and right sides of the operating area were contaminated in 12, 9, 11, and 14 trainees, respectively. Contamination of the treatment cart was observed in 5 trainees. Operator and the surrounding environment can be contaminated during wound debridement. Attention should be paid to hand hygiene, wearing and changing of work clothes, and disinfection of the surrounding environment. Moreover, regular training is recommended.
Using a meta-analysis approach, we conducted a comprehensive evaluation of the effect of neoadjuvant chemotherapy (NACT) on the incidence of surgical site wound infection during immediate breast reconstruction (IBR) following breast cancer. The aim was to provide evidence-based support for the prevention of wound surgical site infection during IBR after breast cancer surgery. Relevant literature on the effects of NACT on IBR in patients with breast cancer published up until May 2023, was retrieved from various databases, including PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang databases, and China Biology Medicine Database. Two researchers performed the literature screening, data collection, and quality assessment of the included studies independently. The meta-analysis was conducted using Stata version 17.0. Fourteen studies involving 3401 patients (599 in the intervention group and 2802 in the control group) were included in the analysis. The incidence of surgical site infection in the NACT group was higher than that in the control group, but the difference between the two groups was not statistically significant (7.17% vs. 4.85%, odds ratio: 1.02, 95% confidence interval: 0.70–1.50, p = 0.902). These findings suggest that NACT does not increase the risk of surgical site infection during IBR. However, owing to the variation in sample size and literature quality among the included studies, randomised controlled trials are needed to confirm the safety of IBR in patients receiving neoadjuvant chemotherapy.
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