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Comorbidity Profiles in Inflammatory Rheumatic Diseases: An Analytical Perspective 炎症性风湿病的共病特征:分析视角
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-27 DOI: 10.1155/2024/3244597
Rezan Koçak Ulucaköy, Hakan Babaoğlu, Esra Kayacan Erdoğan, Kevser Orhan, Ebru Atalar, Serdar Can Güven, Hatice Ecem Konak, Bahar Özdemir Ulusoy, Pınar Akyüz Dağlı, Özlem Karakaş, Hakan Apaydın, Mehmet Akif Eksin, Bünyamin Polat, Serdar Esmer, İsmail Dogan, Yüksel Maraş, Ahmet Omma, Orhan Küçükşahin, Şükran Erten, Berkan Armağan

Background. Inflammatory rheumatic diseases (IRDs) are often associated with multiple comorbidities. Managing comorbidities now seen as important as management of primary IRDs. The aim of this study was to analyse the profiles and prevalence of comorbidities in patients with IRDs and also to highlight the critical need for comprehensive and routine screening for comorbidities. Methods. This study was a retrospective single-center study conducted between 2019 and 2023. IRDs were classified according to the following categories: rheumatoid arthritis, spondyloarthritis, connective tissue diseases, autoinflammatory diseases, Behçet’s disease, large vessel vasculitis (LVV), small vessel vasculitis (SVV), and crystal deposition diseases (CDD). The demographic characteristics and comorbidities (including hypertension, diabetes mellitus, hyperlipidemia, obesity, coronary artery disease, arrhythmia, heart failure, chronic kidney disease, asthma, osteoporosis, thyroid diseases, demyelinating diseases, depression, and malignancies) were obtained from the electronic patient files. Results. The study included 10 417 patients with IRDs (mean age 50.9 ± 14.5 years; 66.8% female). The five most prevalent comorbidities were hypertension (34.8%), obesity (29.1%), diabetes mellitus (14.1%), hyperlipidemia (12.1%), and osteoporosis (9.2%). The Poisson regression analysis demonstrated a significant association between the total number of comorbidities and CDD, LVV, and SVV. The most prevalent comorbidities were cardiovascular risk factors. Furthermore, the prevalence of osteoporosis was high in LVV, and the prevalence of chronic kidney disease and asthma was high in SVV. Conclusion. Our study not only presents observational data but also highlights the critical need for comprehensive and routine screening for comorbidities in patients with rheumatic diseases. We found that CDD followed by LVV and SVV were identified as the rheumatic conditions most associated with comorbidities, and these diseases are most commonly accompanied by cardiovascular risk factors. Additionally, our findings suggest that patients with rheumatological conditions may be underscreened, leading to potential underdiagnosis of comorbidities such as hyperlipidemia, osteoporosis, and possibly malignancies.

背景。炎症性风湿病(IRD)通常伴有多种并发症。目前,治疗合并症与治疗原发性 IRD 同等重要。本研究旨在分析 IRD 患者合并症的概况和患病率,同时强调对合并症进行全面常规筛查的迫切需要。研究方法本研究是一项回顾性单中心研究,在 2019 年至 2023 年期间进行。IRD按以下类别分类:类风湿性关节炎、脊柱关节炎、结缔组织病、自身炎症性疾病、白塞氏病、大血管炎(LVV)、小血管炎(SVV)和晶体沉积病(CDD)。人口统计学特征和合并症(包括高血压、糖尿病、高脂血症、肥胖、冠心病、心律失常、心力衰竭、慢性肾病、哮喘、骨质疏松症、甲状腺疾病、脱髓鞘疾病、抑郁症和恶性肿瘤)均来自患者电子档案。研究结果研究共纳入 10 417 名 IRD 患者(平均年龄为 50.9 ± 14.5 岁;66.8% 为女性)。最常见的五种合并症是高血压(34.8%)、肥胖(29.1%)、糖尿病(14.1%)、高脂血症(12.1%)和骨质疏松症(9.2%)。泊松回归分析表明,合并症总数与 CDD、LVV 和 SVV 之间存在显著关联。最常见的合并症是心血管风险因素。此外,骨质疏松症的患病率在 LVV 中较高,慢性肾病和哮喘的患病率在 SVV 中较高。结论我们的研究不仅提供了观察数据,还强调了对风湿性疾病患者进行全面和常规合并症筛查的迫切需要。我们发现,CDD、LVV 和 SVV 是与合并症关系最密切的风湿病,而这些疾病最常伴有心血管风险因素。此外,我们的研究结果表明,风湿病患者可能筛查不足,导致高脂血症、骨质疏松症等合并症以及可能的恶性肿瘤可能被漏诊。
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引用次数: 0
Dietary Networks Identified by Gaussian Graphical Model and Odds of Major Depressive Disorder: A Case-Control Study 高斯图形模型识别的膳食网络与重度抑郁障碍的几率:病例对照研究
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-26 DOI: 10.1155/2024/8749041
Hossein Shahinfar, Sakineh Shab-Bidar, Mohammad Effatpanah, Reza Askari, Shima Jazayeri

Background. The Gaussian graphical model (GGM) is a new approach that has recently gained attention for identifying dietary patterns. It examines the connections between different food groups and how they are consumed together. The aim of our study was to investigate the link between dietary networks derived from GGM and the odds of major depressive disorder (MDD). Methods. Two hundred drug-free patients with MDD and 200 healthy individuals were enrolled in this age- and sex-matched case-control study. The mean age of the participants was 45.4 years and 67.5% were female. The Beck Depression Inventory-II questionnaire was used for screening depression in the control group. Dietary intake was assessed using a 168-item food frequency questionnaire A GGM was applied to identify dietary networks. The GGM-derived networks were scored, categorized into tertiles, and their association with MDD was determined using a multivariable logistic regression model controlling for energy intake, marital status, job status, income, living status, education, drug use, smoking status, physical activity level, family history of major depressive disorders, comorbidities, and BMI. Results. GGM identified four dietary networks: healthy, prudent, western, and mixed. Nonleafy vegetables in healthy, grains in prudent, and red meat in western dietary networks were identified as hubs, indicating their important position in the identified network. High adherence to a healthy dietary network was associated with decreased odds of MDD (OR: 0.54, 95% CI: 0.31, 0.92; p value = 0.02), whereas, participants at the highest tertile of the western dietary network had greater odds of MDD (OR: 1.80, 95% CI: 1.05, 3.08; p value = 0.03). Neither prudent nor mixed networks were associated with MDD. Conclusions. Healthy and western dietary networks were associated with lower and higher odds of MDD, respectively. Recommendations for reducing the odds of MDD can be focused on increasing nonleafy vegetables and decreasing red meat consumption.

背景。高斯图形模型(GGM)是一种新方法,最近在确定膳食模式方面受到关注。它研究了不同食物组之间的联系以及它们是如何一起消费的。我们的研究旨在调查从高斯图模型中得出的膳食网络与重度抑郁障碍(MDD)发生几率之间的联系。研究方法这项年龄和性别匹配的病例对照研究招募了 200 名未服药的重度抑郁症患者和 200 名健康人。参与者的平均年龄为 45.4 岁,67.5% 为女性。对照组采用贝克抑郁量表-II问卷进行抑郁筛查。采用 168 项食物频率问卷对饮食摄入量进行评估。采用多变量逻辑回归模型对 GGM 衍生的膳食网络进行评分,并将其分为三等分,确定其与 MDD 的关系,该模型控制了能量摄入、婚姻状况、工作状况、收入、生活状况、教育程度、药物使用、吸烟状况、体力活动水平、重度抑郁症家族史、合并症和体重指数。研究结果GGM 确定了四种膳食网络:健康型、谨慎型、西方型和混合型。健康膳食网络中的非叶菜类蔬菜、谨慎膳食网络中的谷物和西方膳食网络中的红肉被确定为枢纽,表明它们在所确定的网络中处于重要位置。对健康膳食网络的高度坚持与 MDD 发生几率的降低有关(OR:0.54,95% CI:0.31,0.92;P 值 = 0.02),而处于西方膳食网络最高层的参与者发生 MDD 的几率更高(OR:1.80,95% CI:1.05,3.08;P 值 = 0.03)。谨慎饮食网络和混合饮食网络均与 MDD 无关。结论健康饮食网络和西方饮食网络分别与较低和较高的 MDD 发生几率有关。降低多发性硬化症几率的建议可侧重于增加非叶菜类蔬菜的摄入量和减少红肉的摄入量。
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引用次数: 0
Review of the Impact and Burden of Urinary Urgency on Adults with Overactive Bladder 尿急对膀胱过度活跃成人的影响和负担回顾
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-25 DOI: 10.1155/2024/5112405
Adrian Wagg, A. Lenore Ackerman, H. Henry Lai, Diane K. Newman

Overactive bladder (OAB) is a prevalent condition that impairs the quality of life in both men and women, and for many, urgency is the most bothersome symptom. Urgency is thought to drive the presentation of the other symptoms (frequency, nocturia, urgency urinary incontinence [UUI]). However, urgency has been understudied in clinical trials, potentially owing to inherent difficulties in its assessment. The definition of urgency related to OAB has been refined over the years, but it may not be easily understood by patients and clinicians, affecting its use in practice. Variability among the tools to measure urgency further complicates the matter. For example, some measure the frequency of urgency episodes and consider reduction of episode frequency as improvement in urgency severity. Others rate the severity of each episode of urgency along a scale, with some including an accompanying incontinence episode as the most severe form. Reduction in UUI episodes is often a primary endpoint in clinical studies, with many studies requiring UUI—sometimes called OAB-wet—as an inclusion criterion, yet approximately two-thirds of those with OAB do not experience UUI. If patients with OAB without UUI (i.e., OAB-dry) are included, they are often not analyzed separately. Thus, it remains unknown if there are differences in treatment outcomes between patients with and without UUI and whether these differences are driven by pathophysiological processes. This narrative review highlights what is known about the pathophysiology of urgency, how urgency affects individuals with OAB, urgency measurement and associated challenges, and assessment of urgency in clinical trials.

膀胱过度活动症(OAB)是一种影响男性和女性生活质量的常见疾病,对许多人来说,尿急是最令人烦恼的症状。尿急被认为是其他症状(尿频、夜尿、尿急尿失禁 [UUI])的诱因。然而,在临床试验中,尿急症状一直未得到充分研究,这可能是由于对其进行评估本身就存在困难。多年来,与 OAB 相关的尿急定义不断完善,但患者和临床医生可能不易理解,从而影响了其在实践中的应用。测量尿急程度的工具各不相同,使问题更加复杂。例如,有些工具测量尿急发作的频率,并将减少发作频率视为改善尿急严重程度。其他一些方法则根据量表对每次尿急发作的严重程度进行评分,其中一些方法将伴随的尿失禁发作作为最严重的形式。尿急发作次数的减少通常是临床研究的主要终点,许多研究都要求将尿急(有时称为 OAB-湿性)作为纳入标准,但约有三分之二的 OAB 患者不会出现尿急。如果纳入了没有 UUI 的 OAB 患者(即干性 OAB),通常也不会对他们进行单独分析。因此,有 UUI 和没有 UUI 的患者在治疗效果上是否存在差异,以及这些差异是否由病理生理过程驱动,目前仍是未知数。本叙述性综述重点介绍了有关急迫感病理生理学、急迫感如何影响 OAB 患者、急迫感测量和相关挑战以及临床试验中急迫感评估的已知知识。
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引用次数: 0
The Impact of Educational Interventions on Nurses’ Perceptions of Parental Support and Attitudes toward Parental Involvement in Neonatal Intensive Care Units 教育干预对新生儿重症监护病房护士对家长支持的看法和对家长参与的态度的影响
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-24 DOI: 10.1155/2024/4816161
Sawsan Abuhammad, Haneen Barakat, Amat-Alkhaleq Mehrass

Aim. To determine the efficacy of interventional programs on nurses’ perceptions of parents’ support and attitudes toward parents’ participation in neonatal care in the neonatal intensive care unit (NICU). Methods. An experimental design was used to determine the efficacy of the interventional program on NICU nurses’ perceptions of parents’ support and attitudes toward parents’ participation in their neonatal care in three hospitals. Nearly 160 nurses from hospitals in North and Middle Jordan participated in the study and were divided into 80 intervention and 80 control groups. Results. The study displayed that nurses had a lower score in the perception of parents’ support and attitude towards their participation in neonatal care in pretest scores than in posttest scores. The mean perception score of parents supported in the control group was 59.17 (SD = 10.1) and in the intervention group was 64.16 (SD = 7.47) (P ≤ 0.01). The mean attitude score of parents’ participation in neonatal care in the control group was 37.08 (SD = 5.76) and that in the intervention group was 38.93 (SD = 5.92) (P = 0.04). Conclusion. The results of the study showed a positive impact of the intervention on nurses’ perceptions of parental support and attitudes toward their participation in neonatal care. Moreover, the study found that the only predictor of NPST and PPAS enhancement among nurses was the implementation of an education program.

目的确定在新生儿重症监护室(NICU)中,干预计划对护士对家长支持的看法以及对家长参与新生儿护理的态度的影响。方法。在三家医院采用实验设计来确定干预项目对新生儿重症监护室护士对父母支持的看法以及对父母参与新生儿护理的态度的影响。来自约旦北部和中部医院的近 160 名护士参与了研究,并被分为 80 个干预组和 80 个对照组。结果显示研究显示,护士对家长参与新生儿护理的支持和态度的感知在前测得分中低于后测得分。对照组家长支持感的平均得分为 59.17(SD = 10.1),干预组为 64.16(SD = 7.47)(P ≤ 0.01)。对照组家长参与新生儿护理的态度平均得分为 37.08(SD = 5.76),干预组为 38.93(SD = 5.92)(P = 0.04)。结论研究结果表明,干预对护士对父母支持的看法以及对父母参与新生儿护理的态度产生了积极影响。此外,研究还发现,在护士中提高 NPST 和 PPAS 的唯一预测因素是教育计划的实施。
{"title":"The Impact of Educational Interventions on Nurses’ Perceptions of Parental Support and Attitudes toward Parental Involvement in Neonatal Intensive Care Units","authors":"Sawsan Abuhammad,&nbsp;Haneen Barakat,&nbsp;Amat-Alkhaleq Mehrass","doi":"10.1155/2024/4816161","DOIUrl":"https://doi.org/10.1155/2024/4816161","url":null,"abstract":"<div>\u0000 <p><i>Aim</i>. To determine the efficacy of interventional programs on nurses’ perceptions of parents’ support and attitudes toward parents’ participation in neonatal care in the neonatal intensive care unit (NICU). <i>Methods</i>. An experimental design was used to determine the efficacy of the interventional program on NICU nurses’ perceptions of parents’ support and attitudes toward parents’ participation in their neonatal care in three hospitals. Nearly 160 nurses from hospitals in North and Middle Jordan participated in the study and were divided into 80 intervention and 80 control groups. <i>Results</i>. The study displayed that nurses had a lower score in the perception of parents’ support and attitude towards their participation in neonatal care in pretest scores than in posttest scores. The mean perception score of parents supported in the control group was 59.17 (SD = 10.1) and in the intervention group was 64.16 (SD = 7.47) (<i>P</i> ≤ 0.01). The mean attitude score of parents’ participation in neonatal care in the control group was 37.08 (SD = 5.76) and that in the intervention group was 38.93 (SD = 5.92) (<i>P</i> = 0.04). <i>Conclusion</i>. The results of the study showed a positive impact of the intervention on nurses’ perceptions of parental support and attitudes toward their participation in neonatal care. Moreover, the study found that the only predictor of NPST and PPAS enhancement among nurses was the implementation of an education program.</p>\u0000 </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/4816161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141967260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative Analysis of Pelvic Floor Muscle Damage Postpartum: Vaginal Delivery vs. Cesarean Section 产后盆底肌肉损伤的比较分析:阴道分娩与剖腹产
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-21 DOI: 10.1155/2024/1169924
Shaohui Chen, Ling Wang, Huitao Guo, Min Jiang, Xiaojun Wang

Background. Evaluation of pelvic floor muscle (PFM) strength damage across different delivery modes, providing insights into potential preventive measures for pelvic floor dysfunctions (PFDs) in the early postpartum period. Aim. Compare the differences in PFM strength and endurance between full-term cesarean section (CS) and vaginal delivery (VD) in the early postpartum period of primiparous women. Methods. The assessment included stress urinary incontinence (SUI), pelvic organ prolapse (POP), and pelvic floor electromyography (PFE). Muscle fiber strength was categorized into four modes at a threshold level of 3: I < 3 II < 3, I < 3 II > 3; I > 3 II < 3, I > 3 II > 3. Multinomial logistic regression was employed for CS and VD, and a sensitivity analysis was conducted using level 2 as the threshold. Outcomes. When muscle fiber strength was categorized into four modes at a threshold level of 3, Type I, and Type II fiber muscle endurance (FME) are differences between the CS and VD groups. Results. The CS and VD groups differed significantly in SUI and anterior and posterior vaginal wall conditions. MDVP was below the normal range in both groups, and MDVP, PFM strength, and PFM endurance did not differ significantly (P > 0.05). Logistic regression results indicated that higher MDVP, Type I, and Type II FME were protective factors when I < 3 in the VD group. However, I < 3-II > 3, higher MDVP, and Type I FME were protective factors (OR: 0.339, 95% CI: 0.223, 0.516) in the CS group. Clinical Implications. The study introduces a nuanced understanding of the impact of different delivery modes on PFM, contributing valuable insights for clinical prevention and treatment strategies in the early postpartum period. Strengths and Limitations. Muscle fiber strength was categorized into four modes and further sensitivity analysis was conducted. This study only conducted a correlation analysis of outcome variables without considering intervenable variables. Conclusions. The VD group had a higher incidence of pelvic floor dysfunction in the early postpartum period than the CS group. Both groups experienced a decline in PFM function without significant differences. CS was primarily associated with Type I muscle fiber damage, while VD was related to both Type I and II muscle fiber damage. Improving PFM endurance is beneficial for muscle strength recovery.

背景。评估不同分娩方式对盆底肌肉(PFM)力量的损伤,为产后早期盆底功能障碍(PFDs)的潜在预防措施提供洞察力。目的比较足月剖宫产(CS)和阴道分娩(VD)在初产妇产后早期盆底肌力量和耐力方面的差异。方法。评估包括压力性尿失禁(SUI)、盆腔器官脱垂(POP)和盆底肌电图(PFE)。肌肉纤维强度在阈值为 3 时分为四种模式:I < 3 II < 3, I < 3 II > 3; I > 3 II < 3, I > 3 II > 3。对 CS 和 VD 采用了多项式逻辑回归,并以 2 级为临界值进行了敏感性分析。结果。在阈值为 3 时,将肌纤维强度分为四种模式,I 型和 II 型纤维肌耐力(FME)在 CS 组和 VD 组之间存在差异。结果。CS 组和 VD 组在 SUI 和阴道前后壁条件方面差异显著。两组的 MDVP 均低于正常范围,MDVP、PFM 强度和 PFM 耐力无显著差异(P >0.05)。逻辑回归结果表明,当 VD 组的 I < 3 时,较高的 MDVP、I 型和 II 型 FME 是保护因素。然而,在 CS 组中,I < 3-II > 3、较高的 MDVP 和 I 型 FME 是保护因素(OR:0.339,95% CI:0.223,0.516)。临床意义。该研究让人们对不同分娩方式对 PFM 的影响有了细致入微的了解,为产后早期的临床预防和治疗策略提供了有价值的见解。优势和局限。肌肉纤维强度分为四种模式,并进行了进一步的敏感性分析。本研究仅对结果变量进行了相关性分析,未考虑可干预变量。结论VD组产后早期盆底功能障碍的发生率高于CS组。两组的盆底肌功能都有所下降,但无显著差异。CS 主要与 I 型肌纤维损伤有关,而 VD 则与 I 型和 II 型肌纤维损伤有关。提高 PFM 的耐力有利于肌肉力量的恢复。
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引用次数: 0
Efficacy of Experimental Propolis-Based Toothpastes on Dentin Hypersensitivity: A Randomized Clinical Trial 实验性蜂胶牙膏对牙本质过敏症的疗效:随机临床试验
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-17 DOI: 10.1155/2024/8563084
Elma Vieira Takeuchi, Alexandra Melo Pingarilho Carneiro, Brennda Lucy Freitas de Paula, Roberta Pimentel de Oliveira, Antônia Patricia Oliveira Barros, Cecy Martins Silva

Background. Propolis is a natural bee product that has garnered attention due to its harmlessness and numerous beneficial biological properties. This randomized, double-blinded, placebo-controlled clinical trial aimed to assess the effect of toothpastes containing different concentrations of propolis (10% and 15%) on the control of dentin hypersensitivity (DH). Methods. From adults aged 18–40 years with DH, 66 teeth were randomly divided into 3 treatment groups as follows (n = 22): control (toothpaste without active ingredient), 10% propolis toothpaste, and 15% propolis toothpaste. DH was assessed thrice (baseline and 15 and 30 days after treatment) by tactile and evaporative stimuli using the visual analog scale. Data were analyzed using Friedman and Kruskal–Wallis tests. A significance level of 5% was used in all analyses. Results. All the groups showed a reduction in DH during the study (p < 0.05). The experimental groups (10% and 15% propolis) showed significantly greater reduction in DH than the control group (p < 0.05) after 30 days of treatment; however, the experimental groups displayed similar results (p > 0.05). Conclusion. Toothpastes containing propolis at concentrations of 10% and 15% were equally effective in controlling DH, regardless of their concentration. Trial Registration. This trial is registered with NCT05083052. Date of registration: 19/10/2021.

背景。蜂胶是一种天然蜂产品,因其无毒无害和多种有益的生物特性而备受关注。这项随机、双盲、安慰剂对照临床试验旨在评估含有不同浓度蜂胶(10%和15%)的牙膏对控制牙本质过敏症(DH)的效果。试验方法从18-40岁患有牙本质过敏症的成年人中随机抽取66颗牙齿,分为以下3个治疗组(n = 22):对照组(不含活性成分的牙膏)、10%蜂胶牙膏和15%蜂胶牙膏。使用视觉模拟量表,通过触觉和蒸发刺激,对DH进行三次评估(基线、治疗后15天和30天)。数据采用弗里德曼检验和 Kruskal-Wallis 检验进行分析。所有分析的显著性水平均为 5%。结果在研究期间,所有组的 DH 都有所下降(p < 0.05)。治疗30天后,实验组(10%和15%蜂胶)的DH下降幅度明显高于对照组(p <0.05);然而,实验组显示出相似的结果(p >0.05)。结论含有10%和15%浓度蜂胶的牙膏对控制DH同样有效。试验注册。该试验已在 NCT05083052 上注册。注册日期:19/10/2021.
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引用次数: 0
Epidemiology of Polytrauma at a Teaching Hospital in Northern Ghana: A Cross-Sectional Study 加纳北部一家教学医院的多发性创伤流行病学:横断面研究
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-16 DOI: 10.1155/2024/4131822
Anwar Sadat Seidu, Abdul Rauf Alhassan, Alexis Dun Bo-ib Buunaaim

Background. Polytrauma refers to multiple life-threatening injuries to more than 2 bodily regions with some significant physiologic derangement. It is a major cause of morbidity and mortality globally. This study aimed to evaluate the epidemiological profile of polytrauma and outline the distribution of extremity fractures among cases in Northern Ghana. Methods. A retrospective cross-sectional study was conducted at the Accident and Emergency Department of Tamale Teaching Hospital. Data were extracted using a data collection tool onto MS Excel, cleaned, and exported onto SPSS version 26 for analysis. Descriptive statistics was used to present data in tables and charts. Analysis of variance (ANOVA) was used to assess whether there was a significant difference in the mean ISS and mean length of stay of the direct causes of death. Results. About 186 out of 5413 attendants to the emergency department were polytrauma, period prevalence of 3.4%. The male-to-female ratio was 1.9 : 1. Young adults (21–40 years) contributed 64% of the participants. The mean age of participants was 32.9 ± 15.4 years, and the mean ISS was 40.6 ± 13.1. Road traffic accidents (68.8%) were the most common cause of polytrauma. The mortality was 33.0%. Traumatic brain injury (TBI) was the most common direct cause of mortality (54.1%). There was a significant mean difference (MD) in the length of stay between multiple organ failure (MOF) and TBI (MD = 3.169, 95% C.I. = 0.48–5.86) and between MOF and hemorrhage (MD = 6.212, 95% C.I. = 2.62–9.80). Most fractures were closed (75.3%) and affected the lower limbs (61.5%). Open reduction and internal fixation were the most common surgery for extremity fractures. Conclusion. We recommend a concerted multidisciplinary policy framework geared towards promoting road safety and reducing accidents in Ghana. We also recommend a tailored robust treatment algorithm for managing traumatic brain injury in our settings to reduce mortality thereof.

背景。多发性创伤是指身体两个以上部位受到多处危及生命的损伤,并伴有一些明显的生理失调。它是全球发病率和死亡率的主要原因。本研究旨在评估多发性创伤的流行病学概况,并概述加纳北部病例中四肢骨折的分布情况。研究方法在塔马利教学医院急诊科进行了一项回顾性横断面研究。使用数据收集工具将数据提取到 MS Excel 中,经过清理后导出到 SPSS 26 版本中进行分析。使用描述性统计以表格和图表的形式呈现数据。方差分析(ANOVA)用于评估直接死亡原因的平均 ISS 和平均住院时间是否存在显著差异。结果在急诊科 5413 名就诊者中,约有 186 人患有多发性创伤,发病率为 3.4%。男女比例为 1.9 :1.其中青壮年(21-40 岁)占 64%。参与者的平均年龄为(32.9 ± 15.4)岁,平均体征(40.6 ± 13.1)。道路交通事故(68.8%)是造成多发性创伤的最常见原因。死亡率为 33.0%。创伤性脑损伤(TBI)是最常见的直接致死原因(54.1%)。多器官功能衰竭(MOF)与创伤性脑损伤(TBI)之间的住院时间平均值(MD)有明显差异(MD = 3.169,95% C.I. = 0.48-5.86),多器官功能衰竭与出血之间的住院时间平均值(MD = 6.212,95% C.I. = 2.62-9.80)也有明显差异。大多数骨折为闭合性骨折(75.3%),受累部位为下肢(61.5%)。四肢骨折最常见的手术是切开复位和内固定。结论我们建议制定协调一致的多学科政策框架,以促进加纳的道路安全并减少交通事故。我们还建议在我们的环境中采用量身定制的稳健治疗算法来处理创伤性脑损伤,以降低死亡率。
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引用次数: 0
Long-Term Outcomes in Patients with ST-Elevation Myocardial Infarction: A Comparative Study of Direct Admissions versus Interhospital Transfers—Insights from a Single-Center Experience in the United Kingdom ST段抬高型心肌梗死患者的长期预后:直接入院与医院间转院的比较研究--来自英国单中心经验的启示
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-14 DOI: 10.1155/2024/7112494
Tarek Abdeldayem, Ashan Gunarathne

Background. Primary percutaneous coronary intervention (PPCI) is the treatment of choice for patients with ST-elevation myocardial infarction (STEMI). Delayed reperfusion leads to increased morbidity and mortality. Secular trends in the impact of interhospital transfers (IT) on long-term mortality in the United Kingdom (UK) have not been previously investigated. We analyzed the impact of IT on 5-year mortality in STEMI patients admitted to a tertiary care center in the UK (East Midlands North). Methods. Data of STEMI patients admitted to Nottingham University Hospitals NHS Trust from 2011 to 2016 were acquired from the National Institute for Cardiovascular Outcomes Research dataset (NICOR) and then combined with local patient-level data and mortality data from National Statistics. The baseline characteristics and mortality data of the interhospital transfer (IT) group were compared to those of a gender and age-matched direct admission (DA) group. Results. Of the total cohort (N = 2386), 29.9% of patients were admitted to the PPCI center via the interhospital transfer (IT) route. Cardiovascular risk profiles in both DA and IT groups were comparable. Five-year Kaplan–Meier (KM) survival analysis revealed better survival in the direct admission group (83% vs. 77.3%; p ≤ 0.001). In multivariate analysis, increased mortality was associated with severe left ventricular impairment (HR 4.7, 95% CI 2.9–7.6), the presence of cardiogenic shock (HR 3.6 (2.7–4.8)), chronic kidney disease (HR 2.56 (1.4–4.5)), smoking (HR 1.45 (1.1–1.8)), male gender (HR 1.7 (1.4–2.01)), and diabetes (HR 1.4 (1.07–1.8)). The radial access and call-to-balloon time less than 120 minutes were also associated with lower mortality (HR 0.52 (0.43–0.63): HR 0.75 (0.61–0.92)). Conclusion. Despite advancements in communication, technology, patient education, transportation systems, and guidelines within the UK’s NHS over the last decade, the delays incurred by IT for STEMI patients remain substantial and are associated with a poor prognosis.

背景。原发性经皮冠状动脉介入治疗(PPCI)是 ST 段抬高型心肌梗死(STEMI)患者的首选治疗方法。延迟再灌注会增加发病率和死亡率。在英国,院间转运(IT)对长期死亡率影响的长期趋势尚未得到研究。我们分析了英国一家三级医疗中心(东米德兰兹北部)收治的 STEMI 患者院间转运对 5 年死亡率的影响。研究方法诺丁汉大学医院 NHS 信托基金会 2011 年至 2016 年收治的 STEMI 患者数据来自国家心血管结果研究所数据集(NICOR),然后与当地患者水平数据和国家统计数据中的死亡率数据相结合。将医院间转运(IT)组的基线特征和死亡率数据与性别和年龄匹配的直接入院(DA)组的基线特征和死亡率数据进行了比较。研究结果在所有组群(N = 2386)中,29.9%的患者是通过医院间转运(IT)途径入住PPCI中心的。DA组和IT组的心血管风险情况相当。五年卡普兰-米尔(KM)生存率分析显示,直接入院组的生存率更高(83% 对 77.3%;P ≤ 0.001)。在多变量分析中,死亡率增加与以下因素有关:严重左心室功能损害(HR 4.7,95% CI 2.9-7.6)、心源性休克(HR 3.6(2.7-4.8))、慢性肾病(HR 2.56(1.4-4.5))、吸烟(HR 1.45(1.1-1.8))、男性(HR 1.7(1.4-2.01))和糖尿病(HR 1.4(1.07-1.8))。桡动脉入路和呼叫至气球时间少于 120 分钟也与较低的死亡率有关(HR 0.52 (0.43-0.63):HR 0.75 (0.61-0.92))。结论尽管过去十年英国国家医疗服务体系在沟通、技术、患者教育、运输系统和指南方面取得了进步,但治疗 STEMI 患者的信息技术仍存在严重延误,且与不良预后有关。
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引用次数: 0
Impact of Diabetes Mellitus on Atrial Fibrillation Recurrence and Major Adverse Cardiac and Cerebrovascular Events following Catheter Ablation 糖尿病对导管消融术后心房颤动复发和主要心脑血管不良事件的影响
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-11 DOI: 10.1155/2024/1087623
Mingjie Lin, Juntao Wang, Bing Rong, Kai Zhang, Tongshuai Chen, Wenqiang Han, Tong Hu, Tianyu Wang, Haonan Deng, Jingquan Zhong, Lin Wu

Introduction. Further evidence is required to understand the impact of preexisting and newly diagnosed diabetes mellitus (DM) on atrial fibrillation (AF) recurrence and major adverse cardiac and cerebrovascular events (MACCEs) following catheter ablation. Materials and Methods. Data from 1,685 patients (1,406 without DM vs. 279 with DM) who underwent AF catheter ablation between 2015 and 2019 were analyzed. These participants were prospectively monitored for incidents of AF recurrence and MACCE over an average period of 58.1 months. Results. A higher incidence of AF recurrence (24.6% vs. 34.4%) and a greater frequency of MACCE (6.5% vs. 9.3%) were observed among DM patients. Kaplan–Meier curves indicated that DM significantly increased the rates of AF recurrence, with a hazard ratio (HR) of 1.506 and a 95% confidence interval (CI) of 1.165–1.948 (p = 0.0003). This association persisted in the propensity-matched cohort. DM was independently predictive of AF recurrence after adjusting for potential risks using Cox regression analysis. Notably, new-onset DM was also found to be an independent predictor of AF recurrence. Similarly, DM was an independent risk of MACCE (HR [95% CI], 2.273 [1.120–4.615], p = 0.023). Conclusions. Both existing DM and newly diagnosed DM were identified as independent risk factors for AF recurrence following ablation; they also significantly impacted MACCE outcomes. This study underscores the urgent need for careful management of DM among individuals undergoing AF ablation in order to reduce the likelihood of arrhythmic relapse. This analysis utilized data from a prospective observational study registered in the Chinese Clinical Trial Registry on July 20, 2014 (ChiCTR-OCH-14004674).

导言。要了解导管消融术后原有和新诊断的糖尿病(DM)对心房颤动(AF)复发和主要不良心脑血管事件(MACCEs)的影响,还需要进一步的证据。材料与方法。对2015年至2019年期间接受房颤导管消融术的1685名患者(1406名无DM,279名有DM)的数据进行了分析。在平均 58.1 个月的时间内,对这些参与者的房颤复发和 MACCE 事件进行了前瞻性监测。结果显示在糖尿病患者中观察到更高的房颤复发率(24.6% 对 34.4%)和更高的 MACCE 频率(6.5% 对 9.3%)。卡普兰-梅耶曲线显示,糖尿病会显著增加房颤复发率,危险比 (HR) 为 1.506,95% 置信区间 (CI) 为 1.165-1.948 (p = 0.0003)。这种关联在倾向匹配队列中持续存在。使用 Cox 回归分析对潜在风险进行调整后,DM 可独立预测房颤复发。值得注意的是,新发的 DM 也是房颤复发的独立预测因素。同样,DM 也是 MACCE 的独立风险因素(HR [95% CI], 2.273 [1.120-4.615], p = 0.023)。结论。现有的 DM 和新诊断的 DM 都被确定为消融术后房颤复发的独立风险因素;它们还对 MACCE 的结果有显著影响。这项研究强调,迫切需要对接受房颤消融术的患者进行细致的 DM 管理,以降低心律失常复发的可能性。本分析采用了2014年7月20日在中国临床试验注册中心注册的一项前瞻性观察研究的数据(ChiCTR-OCH-14004674)。
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引用次数: 0
A Retrospective Analysis of the Characteristics and Clinical Outcomes of Dental Implants Placed in Romanian Patients 对罗马尼亚患者种植牙的特点和临床效果的回顾性分析
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-11 DOI: 10.1155/2024/9036212
Bogdan Gabriel Sandu, Raluca Iulia Juncar, Abel Emanuel Moca, Paul Andrei Țenț, Mihai Juncar

This study aimed to assess the favorable or unfavorable progress of dental implants in a patient sample from Oradea, Romania, considering different variables. A secondary objective was to describe the characteristics of the study sample, as well as different aspects regarding the implants used. This retrospective study analyzed medical records from 1 January 2018, to 1 January 2022, of patients at a dental clinic in Oradea, Romania, who received at least one dental implant. Variables examined included gender, age, systemic diseases, implant location, implant type, and timing of insertion. Clinical and radiological evaluations, using CBCT immediately postplacement and at six months, assessed implant stability and absence of complications. A standardized three-month loading time postinsertion was followed. Exclusion criteria included lack of follow-up, implants placed elsewhere, or incomplete medical records. Quantitative variables were assessed using the Shapiro–Wilk test and nonparametric tests (Mann–Whitney U and Kruskal–Wallis H tests). Fisher’s Exact test analyzed qualitative variables, with Z-tests and Dunn–Bonferroni tests providing detailed results. The study included 344 implants, with 153 (44.5%) placed in female patients and 191 (55.5%) in male patients. Most implants were bone level (61.6%, n = 212) and had a delayed placement (82.6%, n = 284). The majority were situated in the upper posterior dental arch (39.2%, n = 135). Notably, 96.5% (n = 332) of the implants exhibited a positive outcome, irrespective of age, gender, or associated systemic diseases. Immediate postextraction implants displayed a significantly higher association with a negative outcome (41.7% vs. 16.6%), whereas delayed placements were more frequently linked with a positive outcome (83.4% vs. 58.3%) (p = 0.040). Employing established techniques and protocols for dental implant insertion led to consistently positive outcomes, irrespective of the implant type, insertion timing, or location. Patient’s age, gender, and associated diseases did not significantly impact implant outcome, highlighting the robustness of these methods in achieving favorable results.

本研究旨在评估罗马尼亚奥拉迪亚患者样本中种植牙的有利或不利进展,其中考虑到了不同的变量。次要目的是描述研究样本的特征,以及所使用种植体的不同方面。这项回顾性研究分析了罗马尼亚奥拉迪亚一家牙科诊所从 2018 年 1 月 1 日至 2022 年 1 月 1 日至少接受过一次牙科植入手术的患者的医疗记录。研究变量包括性别、年龄、系统性疾病、种植体位置、种植体类型和植入时间。种植体植入后立即使用 CBCT 进行临床和放射学评估,并在 6 个月后使用 CBCT 评估种植体的稳定性和无并发症情况。植入后三个月的装载时间是标准化的。排除标准包括缺乏随访、在其他地方植入种植体或医疗记录不完整。定量变量采用 Shapiro-Wilk 检验和非参数检验(Mann-Whitney U 检验和 Kruskal-Wallis H 检验)进行评估。费雪精确检验分析定性变量,Z检验和邓恩-邦费罗尼检验提供详细结果。研究包括 344 个种植体,其中 153 个(44.5%)植入女性患者体内,191 个(55.5%)植入男性患者体内。大多数种植体位于骨水平(61.6%,n = 212),并且是延迟植入(82.6%,n = 284)。大多数种植体位于上后牙弓(39.2%,n = 135)。值得注意的是,96.5%(332 人)的种植体效果良好,与年龄、性别或相关系统疾病无关。拔牙后即刻种植体与不良结果的关联度明显更高(41.7% 对 16.6%),而延迟种植体与阳性结果的关联度更高(83.4% 对 58.3%)(p = 0.040)。无论种植体类型、植入时间或位置如何,采用成熟的种植体植入技术和方案都能获得一致的良好结果。患者的年龄、性别和相关疾病对种植效果没有明显影响,这突出表明这些方法在取得良好效果方面的稳健性。
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引用次数: 0
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International Journal of Clinical Practice
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