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The Effect of Diabetes Management Shared Care Clinic on Glycated Hemoglobin A1c Compliance and Self-Management Abilities in Patients with Type 2 Diabetes Mellitus 糖尿病管理共享护理诊所对 2 型糖尿病患者糖化血红蛋白 A1c 达标率和自我管理能力的影响
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2023-12-31 DOI: 10.1155/2023/2493634
Tian Jiang, Chao Liu, Ping Jiang, Wenjun Cheng, Xiaohong Sun, Jing Yuan, Qiaoling Wang, Yanlei Wang, Shihui Hong, Haiyan Shen, Dongchun Zhu, Yi Zhang, Fang Dai, Jing Hang, Jiguo Li, Honglin Hu, Qiu Zhang
Objective. We aim to evaluate the impact of diabetes management shared care clinic (DMSCC) on glycated hemoglobin A1c (HbA1c) compliance and self-management abilities in patients with type 2 diabetes mellitus (T2DM). Methods. This study was a prospective cohort study of patients with T2DM participating in the DMSCC. At baseline and after management, the HbA1c levels were measured, the HbA1c compliance rate were calculated, and the Summary of Diabetes Self-Care Activities-6 (SDSCA-6), Diabetes Empowerment Scale-DAWN Short Form (DES-DSF), and Problem Areas in Diabetes Scale—Five-item Short Form (PAID-5) were completed. These pre- and post-management data were compared. Results. A total of 124 eligible patients were enrolled. After the diabetes management of DMSCC, the average HbA1c decreased and the HbA1c compliance rate increased significantly ( < 0.01). SDSCA-6 showed significant improvement in physical activity, glycemic monitoring, smoking ( < 0.01), and taking medication ( < 0.05). DES-DSF suggested a greater willingness to try to effectively treat diabetes ( < 0.05). PAID-5 indicated significant improvement in diabetes-related emotional distress. Conclusion. DMSCC can help patients with T2DM reduce HbA1c, increase HbA1c compliance, improve diabetes self-management behaviors, empowerment, and diabetes-related emotional distress and serve as an effective exploration and practice of diabetes self-management education and support.
目的我们旨在评估糖尿病管理共享护理诊所(DMSCC)对 2 型糖尿病(T2DM)患者糖化血红蛋白 A1c(HbA1c)依从性和自我管理能力的影响。研究方法本研究是一项前瞻性队列研究,研究对象是参加 DMSCC 的 T2DM 患者。在基线和管理后测量 HbA1c 水平,计算 HbA1c 达标率,并填写糖尿病自我护理活动总结-6(SDSCA-6)、糖尿病赋权量表-DAWN 简表(DES-DSF)和糖尿病问题领域量表-五项简表(PAID-5)。对管理前和管理后的数据进行了比较。结果。共有 124 名符合条件的患者入选。经过 DMSCC 的糖尿病管理后,患者的平均 HbA1c 显著下降,HbA1c 达标率显著上升 ( < 0.01)。SDSCA-6在体育锻炼、血糖监测、吸烟(0.01)和服药(0.05)方面均有明显改善。DES-DSF表明患者更愿意尝试有效治疗糖尿病(0.05)。PAID-5表明与糖尿病有关的情绪困扰得到了明显改善。结论DMSCC可以帮助T2DM患者降低HbA1c,提高HbA1c依从性,改善糖尿病自我管理行为、赋权和糖尿病相关情绪困扰,是糖尿病自我管理教育和支持的有效探索和实践。
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引用次数: 0
Real-World Evidence for Risk Factors of Bruises and Fractures from Falls in Patients with Overactive Bladder: A Medical Record Analysis 膀胱过度活动症患者摔伤和骨折风险因素的现实证据:病历分析
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2023-12-27 DOI: 10.1155/2023/3701823
Shigero Miyajima, Taisei Omaru, Tatsu Ishii, Hisatomi Arima, Yozo Shibata, Teruaki Izaki, Nobuhiro Haga
Aim. To identify the risk factors for bruises and fractures from falls in patients with overactive bladder (OAB). Methods. We evaluated 1136 patients with OAB and aged ≥50 years who visited our hospital. Age, sex, frequency of nocturnal urination, and urinary incontinence type were investigated in the 360 eligible patients. Patients were divided into three groups: those patients without falls (no-fall group), those with fall bruises (bruise group), and those with fall fractures (fracture group). The risk factors for bruises and fractures in patients with OAB were evaluated using the logistic regression analysis. In addition, association between the bruises or fractures from falls and the behavior around urination during the night was investigated. Results. The multivariate logistic regression analysis showed that female sex (odds ratio (OR) 2.888,  = 0.030) and nocturnal urination frequency ≥3 times/night (OR vs. ≤2 times/night, 2.940;  = 0.040) were significantly associated with bruises. Nocturnal urination frequency ≥3 times/night (OR vs. ≤2 times/night, 2.835;  = 0.026) and urge incontinence (OR 3.415,  = 0.016) were significantly associated with fractures. Behavior around urination during the night was significantly associated with fractures ( = 0.009). Conclusion. In the real-world clinical setting, increasing nocturnal urination frequency is a common risk factor for bruises and fractures. Also, female sex and urge incontinence were the risk factors for bruises and
目的确定膀胱过度活动症(OAB)患者跌倒造成瘀伤和骨折的风险因素。方法我们对在本院就诊的 1136 名年龄≥50 岁的膀胱过度活动症患者进行了评估。对符合条件的 360 名患者的年龄、性别、夜尿频率和尿失禁类型进行了调查。患者被分为三组:未跌倒患者(未跌倒组)、跌倒瘀伤患者(瘀伤组)和跌倒骨折患者(骨折组)。采用逻辑回归分析评估了 OAB 患者瘀伤和骨折的风险因素。此外,还调查了摔伤或骨折与夜间排尿行为之间的关联。结果多变量逻辑回归分析显示,女性性别(几率比(OR)2.888,=0.030)和夜尿次数≥3次/夜(OR vs. ≤2次/夜,2.940;=0.040)与瘀伤显著相关。夜尿次数≥3次/夜(OR vs. ≤2次/夜,2.835; = 0.026)和急迫性尿失禁(OR 3.415, = 0.016)与骨折明显相关。夜间排尿行为与骨折显著相关(= 0.009)。结论在实际临床环境中,增加夜尿次数是导致瘀伤和骨折的常见风险因素。此外,女性性别和急迫性尿失禁也分别是瘀伤和骨折的危险因素。有急迫性尿失禁的 OAB 患者尤其需要积极干预,以防止夜间排尿时发生骨折。
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引用次数: 0
Changes in Early T-Cell Subsets and Their Impact on Prognosis in Patients with Sepsis: A Single-Center Retrospective Study 败血症患者早期 T 细胞亚群的变化及其对预后的影响:单中心回顾性研究
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2023-12-26 DOI: 10.1155/2023/1688385
Yanhua Li, Youquan Wang, Bin Chen, Jianxing Guo, Dong Zhang
Objective. To analyze the early changes in CD3+, CD4+, and CD8+T-cell subset counts in patients with sepsis and their correlation with prognosis to provide a feasible basis for clinical immunomodulation in sepsis. Methods. This is a single-center retrospective study. The study enrolled sepsis patients (meeting SEPSIS 3.0 definition) who were admitted to the Department of Intensive Care Unit at the First Hospital of Jilin University from July 5th, 2018 to December 5th, 2019 and were aged 18 years or above. In addition, these patients underwent cellular immune testing (CD3+, CD4+, CD8+ T lymphocyte counts, and CD4+/CD8+ ratio) within 24 hours of ICU admission. Patient’s clinical data including age, gender, infection site, APACHE II score, SOFA score, length of ICU stay, mechanical ventilation time, ICU mortality, 28-day mortality, and 3-year survival status were collected. The prognostic indicators and survival of the decreased and nondecreased groups of different subsets of T lymphocyte counts and CD4+/CD8+ ratio were compared. Results. A total of 206 patients were enrolled, with 76.7% having a decrease in CD3+ T lymphocyte count, 76.7% having a decrease in CD4+ T lymphocyte count, and 63.6% having a decrease in CD8+ T lymphocyte count. Furthermore, 21.8% had a lower CD4+/CD8+ ratio. Analysis showed that the CD3+ T lymphocyte count decreased group had a longer length of ICU stay [11 d (4, 21) vs. 7 d (4, 17), ], increased percentage of mechanical ventilation (67.5% vs. 51.0%,
目的分析脓毒症患者 CD3+、CD4+ 和 CD8+T 细胞亚群计数的早期变化及其与预后的相关性,为脓毒症的临床免疫调节提供可行的依据。研究方法这是一项单中心回顾性研究。研究对象为2018年7月5日至2019年12月5日在吉林大学第一医院重症医学科住院的脓毒症患者(符合SEPSIS 3.0定义),年龄在18岁以上。此外,这些患者在入院后24小时内接受了细胞免疫检测(CD3+、CD4+、CD8+ T淋巴细胞计数和CD4+/CD8+比值)。收集了患者的临床数据,包括年龄、性别、感染部位、APACHE II评分、SOFA评分、ICU住院时间、机械通气时间、ICU死亡率、28天死亡率和3年生存状况。比较了不同亚群 T 淋巴细胞计数和 CD4+/CD8+ 比值下降组和未下降组的预后指标和存活率。结果共有 206 名患者入组,其中 76.7% 的患者 CD3+ T 淋巴细胞计数减少,76.7% 的患者 CD4+ T 淋巴细胞计数减少,63.6% 的患者 CD8+ T 淋巴细胞计数减少。此外,21.8%的患者 CD4+/CD8+ 比率较低。分析显示,与CD3+ T淋巴细胞计数未减少组相比,CD3+ T淋巴细胞计数减少组的ICU住院时间更长(11天(4,21)对7天(4,17)),机械通气比例增加(67.5%对51.0%),机械通气时间延长(144小时(48,360)对96小时(48,144))。CD4+/CD8+ 比率下降组的 28 天死亡率高于未下降组(33.3% 对 25.5%),但差异未达到统计学意义。逻辑回归分析显示,CD4+/CD8+比值下降与28天死亡率之间没有明显相关性()。3 年随访显示,CD4+/CD8+ 下降组的存活率低于未下降组(33.3% 对 53.4%)。结论是在败血症早期,大多数患者的 CD3+、CD4+、CD8+T 细胞亚群以及 CD4+/CD8+ 比值均出现下降。CD3+ 和 CD4+/CD8+ 的减少与预后不良有关。
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引用次数: 0
Global, Regional, and National Burden of Ectopic Pregnancy: A 30-Year Observational Database Study 宫外孕的全球、地区和国家负担:一项为期 30 年的观察性数据库研究
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2023-12-18 DOI: 10.1155/2023/3927337
Wang Bo, Zhang Qianyu, Li Mo
Objective. To estimate global, regional, and national trends due to ectopic pregnancy as part of the 2019 Global Burden of Disease study. Methods. We systematically reviewed trends in ectopic pregnancy burden using data from the Global Burden of Disease (GBD) database, including 21 regions, 195 countries, and territories over the past 30 years. The trends of ectopic pregnancy-related incidence, mortality, and disability-adjusted life years (DALYs) attributable to all known risk factors were also analyzed. Age-standardized rates (ASRs) and their estimated annual percentage changes (EAPCs) were also calculated. Results. Incident cases, deaths, and DALYs of ectopic pregnancy increased worldwide in the past 30 years. The age-standardized incidence rate (ASIR) was decreasing (EAPC = −1.14, 95% confidence interval (CI): −1.29 to −0.98), and the age-standardized death (EAPC = −0.9, 95% CI: −1.03 to −0.76) and DALY rate decreased generally (EAPC = −0.83, 95% CI: −0.98 to −0.68). In addition, the burden of ectopic pregnancy is lower in areas with higher socioeconomic development, and significant positive correlations between ASRs and sociodemographic index (SDI) were observed, especially among low-middle SDI, and low SDI quintiles carried the majority burden of ectopic pregnancy. Conclusion. Globally, the incidence, mortality, and DALY rate of ectopic pregnancy had been decreasing from 1990 to 2019. Compared with lower and decreasing ASIR in the high SDI region, ASIR in the low SDI region was always high, indicating the need for ectopic pregnancy treatment improvement and the establishment of more targeted and specific strategies in low SDI countries to reduce the incidence of ectopic pregnancy.
目标:估算宫外孕的全球、地区和国家趋势,作为 2019 年全球疾病负担研究的一部分。作为 2019 年全球疾病负担研究的一部分,估算全球、地区和国家的宫外孕趋势。方法。我们利用全球疾病负担(GBD)数据库中的数据,系统回顾了过去 30 年间 21 个地区、195 个国家和地区的异位妊娠负担趋势。同时还分析了所有已知风险因素导致的宫外孕相关发病率、死亡率和残疾调整生命年(DALYs)的趋势。此外,还计算了年龄标准化比率(ASRs)及其估计年度百分比变化(EAPCs)。结果。在过去的 30 年中,全世界宫外孕的发病率、死亡人数和残疾调整寿命年数都有所增加。年龄标准化发病率(ASIR)呈下降趋势(EAPC =-1.14,95% 置信区间(CI):-1.29 至 -0.98):-年龄标准化死亡率(EAPC = -0.9,95% 置信区间:-1.03 至 -0.76)和残疾调整寿命年率(DALY)普遍下降(EAPC = -0.83,95% 置信区间:-0.98 至 -0.68)。此外,社会经济发展水平较高的地区宫外孕的负担较轻,并且观察到 ASRs 与社会人口指数(SDI)之间存在显著的正相关,尤其是在中低 SDI 的人群中,低 SDI 五分位数人群承担了大部分宫外孕负担。结论从 1990 年到 2019 年,全球异位妊娠的发病率、死亡率和残疾调整生命年率一直在下降。与高SDI地区较低且不断下降的异位妊娠发生率相比,低SDI地区的异位妊娠发生率一直居高不下,这表明低SDI国家需要改善异位妊娠治疗,并制定更有针对性的具体策略来降低异位妊娠的发生率。
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引用次数: 0
Diagnosis, Treatment, and Management for Chronic Coronary Syndrome: A Systematic Review of Clinical Practice Guidelines and Consensus Statements 慢性冠状动脉综合征的诊断、治疗和管理:临床实践指南和共识声明系统回顾
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2023-12-18 DOI: 10.1155/2023/9504108
Tianyue Jing, Yu Wang, Yukun Li, Liangyu Cui, Xingfang Liu, Dasheng Liu, Cong Ren, Tong Yin, Zhiwei Zhao, Jiaheng Wang, Xuejie Han, Liying Wang
Objectives. Management of chronic coronary syndrome (CCS) encompasses a broad spectrum of practices, posing considerable complexity and variability. While guidelines have been established to augment the management quality of CCS, notable disparities persist across their recommendations. This study strives to scrutinize, compare, and reconcile these guideline recommendations pertaining to the diagnosis, treatment, and management of CCS patients. Our goal is to align these recommendations with contemporary clinical practices, thus laying a robust foundation for their pragmatic application in clinical settings. Methods. A comprehensive systematic search was conducted across multiple databases, including PubMed, EMBASE, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, Chinese Biomedical Literature Service System, Chinese Science and Technology Periodical Database, and Chinese Biological Medicine Database. The timeframe for this search spanned from their inception up to May 30, 2022, aiming to collate all published guidelines relevant to CCS. Subsequently, two independent reviewers undertook the task of appraising the quality of these guidelines by utilizing the Appraisal of Guidelines for Research and Evaluation II instrument. Results. The search yielded a total of 10,699 citations. Following a thorough evaluation, fourteen clinical practice guidelines and four consensus statements, each offering specific recommendations for CCS, were selected. The quality of these guidelines showcased a broad spectrum of variation. The domain of “presentation clarity” received the highest accolades, while “applicability” languished at the lower end of the scoring spectrum. On average, the guidelines attained a quality score denoting sufficiency. Furthermore, recommendations across different guidelines for the diagnosis, treatment, and management of CCS displayed a striking level of divergence. Conclusion. The landscape of published CCS guidelines is marked by extensive variations in scope, quality, and recommendations. Hence, there is a compelling need for collaborative efforts amongst multidisciplinary professionals to forge comprehensive, higher-quality evidence-based guidelines; such a concerted approach is paramount to enhance treatment efficacy and health outcomes for patients grappling with CCS.
目的。慢性冠状动脉综合征(CCS)的管理包括广泛的实践,具有相当大的复杂性和可变性。虽然已制定了相关指南来提高慢性冠状动脉综合征的管理质量,但这些指南的建议之间仍存在显著差异。本研究旨在仔细研究、比较和协调这些有关 CCS 患者诊断、治疗和管理的指南建议。我们的目标是使这些建议与当代临床实践相一致,从而为其在临床环境中的实际应用奠定坚实的基础。方法。对多个数据库进行了全面系统的检索,包括 PubMed、EMBASE、中国国家知识基础设施、万方数据库、中国科技期刊数据库、中国生物医学文献服务系统、中国科技期刊数据库和中国生物医学数据库。此次检索的时间跨度从开始至 2022 年 5 月 30 日,旨在整理所有已发表的与社区关怀相关的指南。随后,两位独立审稿人利用研究与评价指南评估工具 II 对这些指南的质量进行了评估。结果。搜索共获得 10,699 条引文。经过全面评估,最终选出了 14 份临床实践指南和 4 份共识声明,每份指南和声明都对儿童疾病防治提出了具体建议。这些指南的质量参差不齐。其中,"表述清晰度 "获得的赞誉最高,而 "适用性 "则处于评分的低端。平均而言,这些指南获得的质量分数表示足够。此外,不同指南对 CCS 的诊断、治疗和管理提出的建议存在显著差异。结论。已出版的 CCS 指南在范围、质量和建议方面存在很大差异。因此,迫切需要多学科专业人员通力合作,制定全面、高质量的循证指南;这种协调一致的方法对于提高 CCS 患者的治疗效果和健康结果至关重要。
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引用次数: 0
Association between Elevated Plasma Vitamin B12 and Short-Term Mortality in Elderly Patients Hospitalized in an Internal Medicine Unit 内科住院老年患者血浆维生素 B12 升高与短期死亡率之间的关系
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2023-12-18 DOI: 10.1155/2023/6652671
Benjamin Eduin, Camille Roubille, Stéphanie Badiou, Jean Paul Cristol, Pierre Fesler
Background. The prognostic value of vitamin B12 blood levels remains controversial. An association between elevated vitamin B12 and mortality has been reported, particularly among elderly patients with cancers and liver or blood diseases. The present study explored the relationship between mortality and elevated vitamin B12 levels in a population of unscheduled inpatients in an internal medicine unit. Methods. This retrospective observational analysis was conducted between August 2014 and December 2018. We compared 165 patients with elevated plasma vitamin B12 levels (>600 pmol/l) with a random sample of 165 patients with normal B12 levels who were hospitalized during the same period. Demographic, clinical, and biological characteristics were assessed during hospitalization. The primary endpoint was all-cause death at 1 year. Results. Patients with elevated B12 were younger, with a lower body mass index and lower plasma albumin than those with normal B12 (75 ± 16 years vs 79 ± 13 years, p = 0.047; 23 ± 5 vs 26 ± 7 kg/m2, ; and 33 ± 5 vs 35 ± 5 g/l,
背景。维生素 B12 血液水平的预后价值仍存在争议。有报道称维生素 B12 升高与死亡率有关,尤其是在患有癌症、肝病或血液病的老年患者中。本研究探讨了内科病房非计划住院患者中死亡率与维生素 B12 水平升高之间的关系。研究方法这项回顾性观察分析在 2014 年 8 月至 2018 年 12 月期间进行。我们将 165 名血浆维生素 B12 水平升高(>600 pmol/l)的患者与随机抽样的 165 名 B12 水平正常的同期住院患者进行了比较。住院期间对人口统计学、临床和生物学特征进行了评估。主要终点是一年后的全因死亡。研究结果与 B12 水平正常的患者相比,B12 升高的患者更年轻、体重指数更低、血浆白蛋白更低(分别为 75 ± 16 岁 vs 79 ± 13 岁,p = 0.047;23 ± 5 vs 26 ± 7 kg/m2,;33 ± 5 vs 35 ± 5 g/l,Ⅴ)。在 B12 升高的患者中,自身免疫性疾病和从重症监护室转诊的比例较高(分别为 11% vs 5%,p = 0.043 和 36% vs 10%)。随访一年后,64 名(39%)B12 升高的患者死亡,而 43 名(26%)B12 正常的患者死亡(p = 0.018)。使用考克斯比例危险回归模型进行多变量分析,并对年龄、性别、体重指数、重症监护室住院情况、白蛋白水平以及是否患有实体瘤或自身免疫性疾病进行调整,结果显示 B12 升高与随访第一年的死亡风险显著相关(危险比:1.71 [1.08-2.7],p = 0.022)。结论B12升高是内科住院患者短期死亡率升高的预警指标,与年龄、癌症或合并症无关。
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引用次数: 0
Changes in Serum Concentrations of Bone Turnover Markers in Healthy Pregnant Women 健康孕妇血清中骨转换标志物浓度的变化
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2023-12-16 DOI: 10.1155/2023/8466349
Yiduo Zhang, Ruiying Li, Jing Zhang, Wenjie Zhou, Fan Yu
Background. Changes in bone metabolism during pregnancy have not received sufficient attention because of the lack of effective screening tools. Bone turnover markers (BTMs) could reflect the changes of bone metabolism. Currently, reference intervals for bone metabolism during normal pregnancy are inconclusive. This study aimed to determine reference intervals for BTMs in pregnant women taking prenatal care and to facilitate clinical research on diseases affecting bone metabolism during pregnancy. Methods. We surveyed 120 low-risk pregnant women attending routine antenatal care from January 2020 to March 2020. The serum levels of procollagen type I N-propeptide (PINP), N-terminal osteocalcin (N-MID), and C-terminal telopeptide of type I collagen (β-CTX) were measured in the first trimester (<13 weeks), second trimester (14–27 weeks), and third trimester (>28 weeks). Reference intervals for BTMs during pregnancy were analyzed. The Kruskal–Wallis test and paired t-test are used to analyze differences between groups. Spearman correlation coefficients expressed the measure of linear association. Results. The bone resorption marker β-CTX in third trimester increases compared to the first trimester and the second trimester ( < 0.001,  < 0.001). The bone formation markers PINP and N-MID were decreased from the first trimester to the second trimester ( = 0.01,  < 0.001) and then raised from the second trimester to the third trimester ( < 0.001,
背景。由于缺乏有效的筛查工具,孕期骨代谢的变化尚未得到足够的重视。骨转换标志物(BTMs)可以反映骨代谢的变化。目前,正常妊娠期骨代谢的参考区间尚无定论。本研究旨在确定接受产前检查的孕妇的骨转换标志物参考区间,并促进对孕期影响骨代谢的疾病的临床研究。研究方法我们调查了 120 名在 2020 年 1 月至 2020 年 3 月期间接受常规产前检查的低风险孕妇。在妊娠头三个月(13 周)、妊娠第二个月(14-27 周)和妊娠第三个月(28 周)分别测定了血清中 I 型胶原 N-肽(PINP)、N-端骨钙素(N-MID)和 I 型胶原 C-端端肽(β-CTX)的水平。对孕期 BTM 的参考区间进行了分析。采用 Kruskal-Wallis 检验和配对 t 检验分析组间差异。斯皮尔曼相关系数表示线性相关的度量。结果。与妊娠前三个月和妊娠后三个月相比,妊娠后三个月的骨吸收标志物β-CTX增加(< 0.001,< 0.001)。骨形成标志物 PINP 和 N-MID 从妊娠前三个月到妊娠后三个月下降(= 0.01,< 0.001),然后从妊娠后三个月到妊娠前三个月上升(< 0.001,< 0.001)。β-CTX/PINP和β-CTX/N-MID这两项骨转换率指数从妊娠头三个月到妊娠后三个月有所上升(< 0.001,< 0.001),然后从妊娠后三个月到妊娠后三个月有所下降(= 0.02,< 0.001)。结论本研究确定了孕妇 BTM 的参考区间,并观察了 BTM 在不同孕期的变化。本研究结果有助于临床监测妊娠期疾病对孕妇骨代谢的影响。
{"title":"Changes in Serum Concentrations of Bone Turnover Markers in Healthy Pregnant Women","authors":"Yiduo Zhang, Ruiying Li, Jing Zhang, Wenjie Zhou, Fan Yu","doi":"10.1155/2023/8466349","DOIUrl":"https://doi.org/10.1155/2023/8466349","url":null,"abstract":"<i>Background</i>. Changes in bone metabolism during pregnancy have not received sufficient attention because of the lack of effective screening tools. Bone turnover markers (BTMs) could reflect the changes of bone metabolism. Currently, reference intervals for bone metabolism during normal pregnancy are inconclusive. This study aimed to determine reference intervals for BTMs in pregnant women taking prenatal care and to facilitate clinical research on diseases affecting bone metabolism during pregnancy. <i>Methods</i>. We surveyed 120 low-risk pregnant women attending routine antenatal care from January 2020 to March 2020. The serum levels of procollagen type I N-propeptide (PINP), N-terminal osteocalcin (N-MID), and C-terminal telopeptide of type I collagen (<i>β</i>-CTX) were measured in the first trimester (&lt;13 weeks), second trimester (14–27 weeks), and third trimester (&gt;28 weeks). Reference intervals for BTMs during pregnancy were analyzed. The Kruskal–Wallis test and paired <i>t</i>-test are used to analyze differences between groups. Spearman correlation coefficients expressed the measure of linear association. <i>Results</i>. The bone resorption marker <i>β</i>-CTX in third trimester increases compared to the first trimester and the second trimester (<svg height=\"8.68572pt\" style=\"vertical-align:-0.0498209pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 8.15071 8.68572\" width=\"8.15071pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g></svg> &lt; 0.001, <svg height=\"8.68572pt\" style=\"vertical-align:-0.0498209pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 8.15071 8.68572\" width=\"8.15071pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g></svg> &lt; 0.001). The bone formation markers PINP and N-MID were decreased from the first trimester to the second trimester (<svg height=\"8.68572pt\" style=\"vertical-align:-0.0498209pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 8.15071 8.68572\" width=\"8.15071pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g></svg> = 0.01, <svg height=\"8.68572pt\" style=\"vertical-align:-0.0498209pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 8.15071 8.68572\" width=\"8.15071pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g></svg> &lt; 0.001) and then raised from the second trimester to the third trimester (<svg height=\"8.68572pt\" style=\"vertical-align:-0.0498209pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 8.15071 8.68572\" width=\"8.15071pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g></svg> &lt; 0.001, ","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138686076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Esketamine Combined with Propofol TCI versus Propofol TCI for Deep Sedation during Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Prospective, Randomized, and Controlled Trial 支气管内超声引导下经支气管针抽吸术中深度镇静的依西他敏联合丙泊酚 TCI 与丙泊酚 TCI 比较:前瞻性随机对照试验
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2023-12-11 DOI: 10.1155/2023/1155126
Sichen Cui, Peiying Huang, Zhanxiong Wei, Ting Guo, Aiyan Zhang, Lining Huang
Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an invasive procedure that required deep sedation to suppress coughing and body movements. Deep sedation, on the other hand, has been shown to cause respiratory and circulatory depression, especially when the airway is shared with the endoscopist. Esketamine is a novel sedative and analgesic with little respiratory inhibition that appears to be an appropriate adjuvant in propofol sedation for EBUS-TBNA. We compared the efficacy and safety of esketamine combined with propofol target-controlled infusion (TCI) and propofol TCI for deep sedation in EBUS-TBNA. Methods. The study included 135 patients with ASA II-III undergoing EBUS-TBNA. They were randomly divided into two groups (group E and group P). Both groups received midazolam (0.01–0.03 mg/kg) and oxycodone (0.07–0.08 mg/kg). Then, patients in group E received 0.3 mg/kg esketamine, propofol TCI, and 0.2 mg·kg−1·h−1 esketamine for sedative maintenance. Patients in group P received only propofol TCI. The primary outcome was the dose of 1% lidocaine administrated by the endoscopist and the times of lidocaine sprays. Secondary outcome indicators were cough score, propofol dosage, patient satisfaction, endoscopist satisfaction, the incidence of sedation-related adverse effects and side effects, and recovery time. Results. Patients in group E were given significantly less lidocaine (4.36 ml/h (2.67–6.00) vs 6.00 ml/h (4.36–7.20), ) and less spraying frequency (2.18 times/h (1.33–3.00) vs 3.00 times/h (2.18–3.60),
背景。支气管内超声引导下经支气管针吸术(EBUS-TBNA)是一种侵入性手术,需要使用深度镇静剂来抑制咳嗽和身体运动。另一方面,深度镇静已被证明会导致呼吸和循环抑制,尤其是在与内镜医师共用气道的情况下。艾司他敏是一种新型镇静镇痛药,对呼吸抑制很小,似乎是异丙酚镇静用于 EBUS-TBNA 的合适辅助药物。我们比较了艾司卡胺联合异丙酚靶控输注(TCI)和异丙酚 TCI 用于 EBUS-TBNA 深度镇静的有效性和安全性。方法。研究纳入了 135 名接受 EBUS-TBNA 的 ASA II-III 级患者。他们被随机分为两组(E 组和 P 组)。两组患者均接受咪达唑仑(0.01-0.03 毫克/千克)和羟考酮(0.07-0.08 毫克/千克)治疗。然后,E 组患者接受 0.3 mg/kg 艾司卡胺、丙泊酚 TCI 和 0.2 mg-kg-1-h-1 艾司卡胺的镇静维持治疗。P 组患者只接受异丙酚 TCI。主要结果是内镜医师使用的1%利多卡因剂量和利多卡因喷洒次数。次要结果指标为咳嗽评分、异丙酚用量、患者满意度、内镜医师满意度、镇静相关不良反应和副作用发生率以及恢复时间。结果。E 组患者的利多卡因用量(4.36 毫升/小时(2.67-6.00)对 6.00 毫升/小时(4.36-7.20))和喷洒次数(2.18 次/小时(1.33-3.00)对 3.00 次/小时(2.18-3.60))明显少于 P 组。此外,E 组在第 30 分钟(T5,84.10 ± 12.91 mmHg 对 79.04 ± 10.01 mmHg,)和第 40 分钟(T6,87.72 ± 15.55 mmHg 对 82.14 ± 10.51 mmHg,)的平均动脉压(MAP)较高。在镇静相关不良事件和副作用、恢复时间、内镜医师满意度和患者满意度方面,两组之间没有明显差异。结论。对于 ASA II-III 级的患者,埃司卡胺作为辅助用药与异丙酚 TCI 深度镇静联合用于 EBUS-TBNA 可以改善镇静效果,减少术中的咳嗽反应,并获得更稳定的血压。但镇静相关的副作用并未减少。该试验的注册号为ChiCTR2200061124。
{"title":"Esketamine Combined with Propofol TCI versus Propofol TCI for Deep Sedation during Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Prospective, Randomized, and Controlled Trial","authors":"Sichen Cui, Peiying Huang, Zhanxiong Wei, Ting Guo, Aiyan Zhang, Lining Huang","doi":"10.1155/2023/1155126","DOIUrl":"https://doi.org/10.1155/2023/1155126","url":null,"abstract":"<i>Background</i>. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an invasive procedure that required deep sedation to suppress coughing and body movements. Deep sedation, on the other hand, has been shown to cause respiratory and circulatory depression, especially when the airway is shared with the endoscopist. Esketamine is a novel sedative and analgesic with little respiratory inhibition that appears to be an appropriate adjuvant in propofol sedation for EBUS-TBNA. We compared the efficacy and safety of esketamine combined with propofol target-controlled infusion (TCI) and propofol TCI for deep sedation in EBUS-TBNA. <i>Methods</i>. The study included 135 patients with ASA II-III undergoing EBUS-TBNA. They were randomly divided into two groups (group E and group P). Both groups received midazolam (0.01–0.03 mg/kg) and oxycodone (0.07–0.08 mg/kg). Then, patients in group E received 0.3 mg/kg esketamine, propofol TCI, and 0.2 mg·kg<sup>−1</sup>·h<sup>−1</sup> esketamine for sedative maintenance. Patients in group P received only propofol TCI. The primary outcome was the dose of 1% lidocaine administrated by the endoscopist and the times of lidocaine sprays. Secondary outcome indicators were cough score, propofol dosage, patient satisfaction, endoscopist satisfaction, the incidence of sedation-related adverse effects and side effects, and recovery time. <i>Results</i>. Patients in group E were given significantly less lidocaine (4.36 ml/h (2.67–6.00) vs 6.00 ml/h (4.36–7.20), <span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 28.182 9.2729\" width=\"28.182pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,44.605,0)\"></path></g></svg>)</span></span> and less spraying frequency (2.18 times/h (1.33–3.00) vs 3.00 times/h (2.18–3.60), <span><svg height=\"9.2729pt\" style=\"vertical-align:-0.6370001pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 9.2729\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-91\"></use></g></svg><span></span><span><svg height=\"9.2729pt\" style=\"vertical-al","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138569785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Left Ventricular Mass Index in End-Stage Renal Disease Patients during Hemodialysis and Continuous Ambulatory Peritoneal Dialysis 血液透析和连续不卧床腹膜透析期间终末期肾病患者的左心室质量指数
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2023-12-11 DOI: 10.1155/2023/8816478
Nghia Nhu Nguyen, Phieu Van Duong, Tan Huynh Ngoc Mai, Nghia Hoang Vo, Dinh Kim Luong, Toan Hoang Ngo
Background. One of the primary reasons for high mortality in end-stage renal disease (ESRD) is cardiovascular disease in patients with renal replacement therapy (RRT). Left ventricular hypertrophy (LVH) significantly predicts mortality and cardiovascular events. Objectives. We assess the left ventricular mass index change in two dialysis methods: hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). The factors associated with increased left ventricular mass index (LVMI). Materials and Methods. We recruit more than 50 HD patients and 45 CAPD patients with LVH of similar age, gender, dialysis duration, and LVMI for one-year follow-up. Results. The LVMI in the group of HD patients after one year increased from 180.28 ± 45.32 g/m2 to 212.58 ± 66.22 g/m2 (p = 0.001), while the LVMI in the group of patients with CAPD increased from 190.16 ± 66.01 g/m2 to 197.42 ± 78 g/m2 (p = 0.32). Multivariable logistic regression analysis, we demonstrated that dialysis by HD (β = −1,167, 95% CI: 0.104–0.938, p = 0.036) and anemia treatment lower the goals (β = 1.9566, 95% CI: 1.466–34.094, p = 0.015) were two factors associated with the progression of the LVMI. Conclusion. The LVH of end-stage renal disease patients with HD treatment is worse than CAPD treatment after a follow-up in one year. Dialysis by periodic hemodialysis and anemia treatment that fails to achieve the goal are risk factors associated with increased progression of LVMI in patients with ESRD.
背景。终末期肾病(ESRD)患者死亡率高的主要原因之一是接受肾脏替代疗法(RRT)患者的心血管疾病。左心室肥厚(LVH)可显著预测死亡率和心血管事件。我们的目标是我们评估了血液透析(HD)和持续非卧床腹膜透析(CAPD)两种透析方法中左心室质量指数的变化。左心室质量指数(LVMI)增加的相关因素。材料和方法。我们招募了年龄、性别、透析时间和左心室质量指数相似的 50 多名 HD 患者和 45 名 CAPD 患者,进行为期一年的随访。结果。一年后,HD 患者组的 LVMI 从 180.28 ± 45.32 g/m2 增加到 212.58 ± 66.22 g/m2 (P = 0.001),而 CAPD 患者组的 LVMI 从 190.16 ± 66.01 g/m2 增加到 197.42 ± 78 g/m2 (P = 0.32)。多变量逻辑回归分析表明,HD 透析(β = -1,167, 95% CI: 0.104-0.938, p = 0.036)和降低目标的贫血治疗(β = 1.9566, 95% CI: 1.466-34.094, p = 0.015)是 LVMI 增高的两个相关因素。结论随访一年后,接受 HD 治疗的终末期肾病患者的 LVH 比接受 CAPD 治疗的患者更差。通过周期性血液透析进行透析和贫血治疗未能达到目标是与 ESRD 患者 LVMI 增大相关的风险因素。
{"title":"Left Ventricular Mass Index in End-Stage Renal Disease Patients during Hemodialysis and Continuous Ambulatory Peritoneal Dialysis","authors":"Nghia Nhu Nguyen, Phieu Van Duong, Tan Huynh Ngoc Mai, Nghia Hoang Vo, Dinh Kim Luong, Toan Hoang Ngo","doi":"10.1155/2023/8816478","DOIUrl":"https://doi.org/10.1155/2023/8816478","url":null,"abstract":"<i>Background</i>. One of the primary reasons for high mortality in end-stage renal disease (ESRD) is cardiovascular disease in patients with renal replacement therapy (RRT). Left ventricular hypertrophy (LVH) significantly predicts mortality and cardiovascular events. <i>Objectives</i>. We assess the left ventricular mass index change in two dialysis methods: hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). The factors associated with increased left ventricular mass index (LVMI). <i>Materials and Methods</i>. We recruit more than 50 HD patients and 45 CAPD patients with LVH of similar age, gender, dialysis duration, and LVMI for one-year follow-up. <i>Results</i>. The LVMI in the group of HD patients after one year increased from 180.28 ± 45.32 g/m<sup>2</sup> to 212.58 ± 66.22 g/m<sup>2</sup> (<i>p</i> = 0.001), while the LVMI in the group of patients with CAPD increased from 190.16 ± 66.01 g/m<sup>2</sup> to 197.42 ± 78 g/m<sup>2</sup> (<i>p</i> = 0.32). Multivariable logistic regression analysis, we demonstrated that dialysis by HD (<i>β</i> = −1,167, 95% CI: 0.104–0.938, <i>p</i> = 0.036) and anemia treatment lower the goals (<i>β</i> = 1.9566, 95% CI: 1.466–34.094, <i>p</i> = 0.015) were two factors associated with the progression of the LVMI. <i>Conclusion</i>. The LVH of end-stage renal disease patients with HD treatment is worse than CAPD treatment after a follow-up in one year. Dialysis by periodic hemodialysis and anemia treatment that fails to achieve the goal are risk factors associated with increased progression of LVMI in patients with ESRD.","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138569407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quality of Life and Psychometric Characteristics of Syrian Refugee Physicians Who Migrated to Turkey: A Cross-Sectional Study 移居土耳其的叙利亚难民医生的生活质量和心理测量特征:一项横断面研究
IF 2.6 4区 医学 Q2 Medicine Pub Date : 2023-12-06 DOI: 10.1155/2023/6654937
Ahmet Keskin, Basri Furkan Dagcioglu
Background. The concept of migration comes with various problems, affecting the quality of life and psychological state of immigrants. This study aimed to investigate the quality of life and depression and anxiety states of physicians who immigrated to Turkey after the civil war that started in Syria in 2011. Methods. In this cross-sectional study, a sociodemographic questionnaire form, the short version of the World Health Organization’s quality of life assessment tool (WHOQOL-BREF), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were applied to Syrian doctors who received integration training to work in refugee health centers established for immigrants in Turkey. Results. A total of 570 participants were included in the study. The median scores of WHOQOL-BREF domains of the participants were 75 for DOM1 (min: 25, max: 100, IQR: 18), 69 for DOM2 (min: 6, max: 100, IQR: 25), 69 for DOM3 (min: 0, max: 100, IQR: 19), and 63 for DOM4 (min: 0, max: 94, IQR: 19). The median BDI score of the participants was 7 (min: 0, max: 41, IQR: 8), and the median BAI score was 5 (min: 0, max: 50, IQR: 8). Having primary care experience, having knowledge about the Turkish healthcare system, believing that they can adapt to work in refugee health centers, and not having a plan to return to their country were found to be associated with a higher score in at least one of the WHOQOL-BREF subdomains. Planning to turn back their country was significantly associated with higher BAI scores. Conclusions. The overall quality of life of most refugee physicians in Turkey was high, and the BDI and BAI scores were also below the threshold values. Further qualitative studies that allow in-depth analyses may reveal underlying factors for this situation.
背景。移民观念带来了各种各样的问题,影响着移民的生活质量和心理状态。本研究旨在调查2011年叙利亚内战爆发后移民到土耳其的医生的生活质量、抑郁和焦虑状态。方法。在这项横断面研究中,社会人口调查问卷、世界卫生组织生活质量评估工具(WHOQOL-BREF)的简短版本、贝克抑郁量表(BDI)和贝克焦虑量表(BAI)应用于接受融合培训的叙利亚医生,这些医生在土耳其为移民建立的难民健康中心工作。结果。共有570名参与者参与了这项研究。参与者的WHOQOL-BREF域的中位数得分为:DOM1为75 (min: 25, max: 100, IQR: 18), DOM2为69 (min: 6, max: 100, IQR: 25), DOM3为69 (min: 0, max: 100, IQR: 19), DOM4为63 (min: 0, max: 94, IQR: 19)。参与者的BDI得分中位数为7 (min: 0, max: 41, IQR: 8), BAI得分中位数为5 (min: 0, max: 50, IQR: 8)。具有初级保健经验,了解土耳其医疗保健系统,相信他们可以适应在难民保健中心工作,并且没有返回本国的计划被发现与至少一个WHOQOL-BREF子域的较高得分相关。计划回国与更高的BAI分数显著相关。结论。土耳其大多数难民医生的总体生活质量较高,BDI和BAI得分也低于阈值。允许深入分析的进一步定性研究可能揭示这种情况的潜在因素。
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International Journal of Clinical Practice
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