Objective: To investigate the suicide risk factors among caregivers of individuals with depression who may develop suicidal ideation due to the ongoing challenges of managing the patient's mood fluctuations.
Methods: This cross-sectional study enrolled dyads of patients with depression and their caregivers from a medical centre. The assessment included a psychiatric diagnostic interview, the Hospital Anxiety and Depression Scale, the List of Threatening Experiences, Benefit Finding Scale, Numerical Pain Rating Scale, Stigma Subscale of the Explanatory Model Interview Catalogue, Big Five Inventory-10, the Family APGAR Index and the Suicide Assessment Scale. Univariate and multivariate regression analysis were used to explore the interrelationship between the mental health of patients and caregivers.
Results: Among the 125 caregivers, 60.0% (n = 75) were females. The most common psychiatric diagnoses were depressive disorders (33 of 125; 26.4%), followed by anxiety disorders (21 of 125; 16.8%) and insomnia disorder (19 of 125; 15.2%). There was a significant association between the stressful life events of depressive patients and the suicide risk of their caregivers. The severity of anxiety and depression in caregivers was significantly associated with the suicide risk among the caregivers.
Conclusion: A relationship may exist between the psychological well-being of patients with depression and their caregivers.
{"title":"Suicide risks among caregivers of patients with depressive disorders.","authors":"Chia-Chi Lin, Yu-Chi Huang, Yu Lee, Pao-Yen Lin, Nien-Mu Chiu, Chi-Fa Hung, Liang-Jen Wang","doi":"10.1177/03000605241266226","DOIUrl":"10.1177/03000605241266226","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the suicide risk factors among caregivers of individuals with depression who may develop suicidal ideation due to the ongoing challenges of managing the patient's mood fluctuations.</p><p><strong>Methods: </strong>This cross-sectional study enrolled dyads of patients with depression and their caregivers from a medical centre. The assessment included a psychiatric diagnostic interview, the Hospital Anxiety and Depression Scale, the List of Threatening Experiences, Benefit Finding Scale, Numerical Pain Rating Scale, Stigma Subscale of the Explanatory Model Interview Catalogue, Big Five Inventory-10, the Family APGAR Index and the Suicide Assessment Scale. Univariate and multivariate regression analysis were used to explore the interrelationship between the mental health of patients and caregivers.</p><p><strong>Results: </strong>Among the 125 caregivers, 60.0% (<i>n</i> = 75) were females. The most common psychiatric diagnoses were depressive disorders (33 of 125; 26.4%), followed by anxiety disorders (21 of 125; 16.8%) and insomnia disorder (19 of 125; 15.2%). There was a significant association between the stressful life events of depressive patients and the suicide risk of their caregivers. The severity of anxiety and depression in caregivers was significantly associated with the suicide risk among the caregivers.</p><p><strong>Conclusion: </strong>A relationship may exist between the psychological well-being of patients with depression and their caregivers.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792641","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}
Pub Date : 2024-07-01DOI: 10.1177/03000605241266233
Jihan Muhaidat, Aiman Albatayneh
Objectives: To enhance the accuracy of forecasting future coronavirus disease 2019 (COVID-19) cases and trends by identifying and analyzing correlations between the daily case counts of different countries reported between January 2020 and January 2023, to uncover significant links in COVID-19 patterns between nations, allowing for real-time, precise predictions of disease spread based on observed trends in correlated countries.
Methods: Daily COVID-19 cases for each country were tracked between January 2020 and January 2023 to identify correlations between nations. Current case data were obtained from reliable sources, such as Johns Hopkins University and the World Health Organization. Data were analyzed in Microsoft Excel using Pearson's correlation coefficient to assess the strength of connections.
Results: Strong correlations (r > 0.80) were revealed between the daily reported COVID-19 case counts of numerous countries across various continents. Specifically, 62 nations showed significant correlations with at least one correlated (connected) country per nation. These correlations indicate a similarity in COVID-19 trends over the past 3 or more years.
Conclusion: This study addresses the gap in country-specific correlations within COVID-19 forecasting methodologies. The proposed method offers essential real-time insights to aid effective government and organizational planning in response to the pandemic.
{"title":"COVID-19 trends across borders: Identifying correlations among countries.","authors":"Jihan Muhaidat, Aiman Albatayneh","doi":"10.1177/03000605241266233","DOIUrl":"10.1177/03000605241266233","url":null,"abstract":"<p><strong>Objectives: </strong>To enhance the accuracy of forecasting future coronavirus disease 2019 (COVID-19) cases and trends by identifying and analyzing correlations between the daily case counts of different countries reported between January 2020 and January 2023, to uncover significant links in COVID-19 patterns between nations, allowing for real-time, precise predictions of disease spread based on observed trends in correlated countries.</p><p><strong>Methods: </strong>Daily COVID-19 cases for each country were tracked between January 2020 and January 2023 to identify correlations between nations. Current case data were obtained from reliable sources, such as Johns Hopkins University and the World Health Organization. Data were analyzed in Microsoft Excel using Pearson's correlation coefficient to assess the strength of connections.</p><p><strong>Results: </strong>Strong correlations (r > 0.80) were revealed between the daily reported COVID-19 case counts of numerous countries across various continents. Specifically, 62 nations showed significant correlations with at least one correlated (connected) country per nation. These correlations indicate a similarity in COVID-19 trends over the past 3 or more years.</p><p><strong>Conclusion: </strong>This study addresses the gap in country-specific correlations within COVID-19 forecasting methodologies. The proposed method offers essential real-time insights to aid effective government and organizational planning in response to the pandemic.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792673","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}
Platelet-rich plasma (PRP), a blood product containing high concentrations of platelets, has been increasingly used for the treatment of a number of diseases because of its anti-inflammatory and regenerative properties. PRP is generally obtained from the patient's own peripheral blood when used in clinical applications, but allogeneic PRP extracted from umbilical cord blood has also attracted attention due to its unique advantages. The main purpose of this narrative review was to summarize the research and clinical application of cord blood-derived PRP (CB-PRP) in the treatment of diseases up to April 2024. This review also discusses the differences between CB-PRP and autologous PRP (A-PRP). A thorough search of PubMed® and Clinicaltrials.gov identified 13 articles and four clinical trials. To date, CB-PRP has been primarily studied in the fields of orthopaedics, dermatology, neurology, obstetrics/gynaecology and ophthalmology. This is likely to be because this research is relatively novel. Considering the differences between the characteristics of A-PRP and CB-PRP, it is thought that CB-PRP might hold more promise for broader applications in the future.
{"title":"Application of cord blood-derived platelet-rich plasma in the treatment of diseases.","authors":"Yukuan Tang, Yongsheng Li, Hanwei Chen, Yuyang Huang, Chen Huang, Wei Wei","doi":"10.1177/03000605241263729","DOIUrl":"10.1177/03000605241263729","url":null,"abstract":"<p><p>Platelet-rich plasma (PRP), a blood product containing high concentrations of platelets, has been increasingly used for the treatment of a number of diseases because of its anti-inflammatory and regenerative properties. PRP is generally obtained from the patient's own peripheral blood when used in clinical applications, but allogeneic PRP extracted from umbilical cord blood has also attracted attention due to its unique advantages. The main purpose of this narrative review was to summarize the research and clinical application of cord blood-derived PRP (CB-PRP) in the treatment of diseases up to April 2024. This review also discusses the differences between CB-PRP and autologous PRP (A-PRP). A thorough search of PubMed® and Clinicaltrials.gov identified 13 articles and four clinical trials. To date, CB-PRP has been primarily studied in the fields of orthopaedics, dermatology, neurology, obstetrics/gynaecology and ophthalmology. This is likely to be because this research is relatively novel. Considering the differences between the characteristics of A-PRP and CB-PRP, it is thought that CB-PRP might hold more promise for broader applications in the future.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788288","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}
Pub Date : 2024-07-01DOI: 10.1177/03000605241261986
Lingling Zhao, Minqiang Du, Ruihong Zhang
Objective: To observe the effects of 4 weeks of voluntary wheel running on depressive-like behavior in a rat chronic stress-induced depression model to explore the anti-depressive mechanism of exercise.
Methods: In this observational study, 36 Sprague-Dawley rats were randomly divided into control, stress model, and stress exercise groups (12 rats/group). The control group received no intervention, and the stress model and stress exercise group rats underwent chronic mild unpredictable stress and isolation. The stress exercise group rats also underwent 4 weeks of voluntary wheel running. Behavioral changes and hippocampal protein and mRNA expression levels were detected.
Results: Voluntary wheel running significantly increased horizontal and vertical movements, sucrose intake, and the sucrose preference percentage and reduced immobility time in the forced swimming test in depression model rats. The hippocampal tumor necrosis factor-α, interleukin (IL)-6, IL-1β, and quinolinic acid levels were significantly decreased, while the IL-4, IL-10, and kynurenic acid levels were significantly increased. Kynurenine-3-monooxygenase and 3-hydroxyanthranilate-3, 4-dioxygenase mRNA levels were downregulated, and kynurenine aminotransferase mRNA was upregulated.
Conclusion: Voluntary wheel running improved depressive-like behavior in depression model rats. The mechanism may be related to a kynurenine pathway metabolite level imbalance, which has neurotoxic and neuroprotective effects, caused by long-term voluntary wheel running.
{"title":"The improvement effect of exercise on rats with chronic stress-induced depression-like behavior: a discussion based on the kynurenine pathway.","authors":"Lingling Zhao, Minqiang Du, Ruihong Zhang","doi":"10.1177/03000605241261986","DOIUrl":"10.1177/03000605241261986","url":null,"abstract":"<p><strong>Objective: </strong>To observe the effects of 4 weeks of voluntary wheel running on depressive-like behavior in a rat chronic stress-induced depression model to explore the anti-depressive mechanism of exercise.</p><p><strong>Methods: </strong>In this observational study, 36 Sprague-Dawley rats were randomly divided into control, stress model, and stress exercise groups (12 rats/group). The control group received no intervention, and the stress model and stress exercise group rats underwent chronic mild unpredictable stress and isolation. The stress exercise group rats also underwent 4 weeks of voluntary wheel running. Behavioral changes and hippocampal protein and mRNA expression levels were detected.</p><p><strong>Results: </strong>Voluntary wheel running significantly increased horizontal and vertical movements, sucrose intake, and the sucrose preference percentage and reduced immobility time in the forced swimming test in depression model rats. The hippocampal tumor necrosis factor-α, interleukin (IL)-6, IL-1β, and quinolinic acid levels were significantly decreased, while the IL-4, IL-10, and kynurenic acid levels were significantly increased. Kynurenine-3-monooxygenase and 3-hydroxyanthranilate-3, 4-dioxygenase mRNA levels were downregulated, and kynurenine aminotransferase mRNA was upregulated.</p><p><strong>Conclusion: </strong>Voluntary wheel running improved depressive-like behavior in depression model rats. The mechanism may be related to a kynurenine pathway metabolite level imbalance, which has neurotoxic and neuroprotective effects, caused by long-term voluntary wheel running.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788339","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}
Pub Date : 2024-07-01DOI: 10.1177/03000605241266221
Fei Gao, Changhu Dong, Mingzhu Du, Zhenzhen Li, Yanping Song, Guang Li
Objective: Raising awareness of acquired hemophilia A (AHA) and early diagnosis is critical to reduce the associated mortality rate. We aimed to characterize acquired hemophilia in Chinese patients and evaluate the effectiveness of immunotherapy.
Methods: The clinical characteristics, laboratory test data, therapeutic approaches, and outcomes of 20 patients with AHA who were admitted to Xi'an Central Hospital between January 2012 and December 2020 were retrospectively studied.
Results: Nine of the patients (45%) were treated by single glucocorticoid administration; three (15%) with cyclophosphamide (CP) in combination with a glucocorticoid; four individuals (20%) received a combination therapy of rituximab with CP and glucocorticoid or rituximab with CP, vincristine, and a glucocorticoid; three (15%) by injection of human immunoglobulin in combination with a glucocorticoid; and one (5%) with CP alone. Six patients (30%) achieved total remission and 11 (55%) partial remission (PR), but three (15%) did not enter remission, indicating an objective response rate of 85%.
Conclusion: Combination therapy with rituximab or intravenous human immunoglobulin achieves superior results in some patients with AHA. Immunosuppression and the administration of coagulation factors can rapidly control the disease and are efficacious, but >50% of patients only achieved PR. These findings suggest that the complete elimination of inhibitors requires prolonged immunosuppression therapy.
目的:提高对获得性血友病 A(AHA)的认识和早期诊断对于降低相关死亡率至关重要。我们旨在了解中国获得性血友病患者的特征,并评估免疫疗法的效果:方法:我们对西安市中心医院在2012年1月至2020年12月期间收治的20名A型血友病患者的临床特征、实验室检测数据、治疗方法和结果进行了回顾性研究:其中9名患者(45%)接受了单一糖皮质激素治疗;3名患者(15%)接受了环磷酰胺(CP)联合糖皮质激素治疗;4名患者(20%)接受了利妥昔单抗联合CP和糖皮质激素治疗或利妥昔单抗联合CP、长春新碱和糖皮质激素治疗;3名患者(15%)接受了注射人免疫球蛋白联合糖皮质激素治疗;1名患者(5%)接受了单纯CP治疗。6名患者(30%)获得了完全缓解,11名患者(55%)获得了部分缓解(PR),但有3名患者(15%)未获得缓解,客观反应率为85%:结论:利妥昔单抗或静脉注射人免疫球蛋白的联合疗法可为部分 AHA 患者带来更好的治疗效果。免疫抑制和使用凝血因子可迅速控制病情,疗效显著,但超过 50% 的患者仅获得 PR。这些研究结果表明,要完全消除抑制剂,需要长时间的免疫抑制治疗。
{"title":"Retrospective study of the clinical manifestations and efficacy of immunotherapy for patients with acquired hemophilia A.","authors":"Fei Gao, Changhu Dong, Mingzhu Du, Zhenzhen Li, Yanping Song, Guang Li","doi":"10.1177/03000605241266221","DOIUrl":"10.1177/03000605241266221","url":null,"abstract":"<p><strong>Objective: </strong>Raising awareness of acquired hemophilia A (AHA) and early diagnosis is critical to reduce the associated mortality rate. We aimed to characterize acquired hemophilia in Chinese patients and evaluate the effectiveness of immunotherapy.</p><p><strong>Methods: </strong>The clinical characteristics, laboratory test data, therapeutic approaches, and outcomes of 20 patients with AHA who were admitted to Xi'an Central Hospital between January 2012 and December 2020 were retrospectively studied.</p><p><strong>Results: </strong>Nine of the patients (45%) were treated by single glucocorticoid administration; three (15%) with cyclophosphamide (CP) in combination with a glucocorticoid; four individuals (20%) received a combination therapy of rituximab with CP and glucocorticoid or rituximab with CP, vincristine, and a glucocorticoid; three (15%) by injection of human immunoglobulin in combination with a glucocorticoid; and one (5%) with CP alone. Six patients (30%) achieved total remission and 11 (55%) partial remission (PR), but three (15%) did not enter remission, indicating an objective response rate of 85%.</p><p><strong>Conclusion: </strong>Combination therapy with rituximab or intravenous human immunoglobulin achieves superior results in some patients with AHA. Immunosuppression and the administration of coagulation factors can rapidly control the disease and are efficacious, but >50% of patients only achieved PR. These findings suggest that the complete elimination of inhibitors requires prolonged immunosuppression therapy.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855685","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}
Pub Date : 2024-06-01DOI: 10.1177/03000605241257776
Wenjing Zhai, Hao Liu, Jinrui Li, Haili Xin
Pregabalin is a prescription medicine that has recently been approved for individuals who suffer from fibromyalgia, neuropathic pain, anxiety disorder, or epilepsy. Pregabalin has the side effects of dizziness, sleepiness, and angioedema. Pregabalin-induced rhabdomyolysis has been rarely reported, with only four reports to date. We report two cases of rhabdomyolysis after pregabalin treatment. A man aged older than 90 years presented with exhaustion, muscle aches, and a high serum creatine kinase concentration after taking 75 mg of pregabalin on the first day of treatment. A woman in her 90s with long-term use of pregabalin presented with considerably elevated serum creatine kinase concentrations. Both patients had a long history of taking statins. Pregabalin therapy was stopped, high-volume intravenous fluids were administered, and serum electrolytes were frequently checked. Alkalinisation was performed with excellent outcomes. The Naranjo Adverse Drug Reaction scale and previous research suggest an association between pregabalin and rhabdomyolysis. Clinicians should be alert to the possibility of rhabdomyolysis occurring with the use of pregabalin, especially when taking statins.
{"title":"Pregabalin-induced rhabdomyolysis: a case series and literature analysis.","authors":"Wenjing Zhai, Hao Liu, Jinrui Li, Haili Xin","doi":"10.1177/03000605241257776","DOIUrl":"10.1177/03000605241257776","url":null,"abstract":"<p><p>Pregabalin is a prescription medicine that has recently been approved for individuals who suffer from fibromyalgia, neuropathic pain, anxiety disorder, or epilepsy. Pregabalin has the side effects of dizziness, sleepiness, and angioedema. Pregabalin-induced rhabdomyolysis has been rarely reported, with only four reports to date. We report two cases of rhabdomyolysis after pregabalin treatment. A man aged older than 90 years presented with exhaustion, muscle aches, and a high serum creatine kinase concentration after taking 75 mg of pregabalin on the first day of treatment. A woman in her 90s with long-term use of pregabalin presented with considerably elevated serum creatine kinase concentrations. Both patients had a long history of taking statins. Pregabalin therapy was stopped, high-volume intravenous fluids were administered, and serum electrolytes were frequently checked. Alkalinisation was performed with excellent outcomes. The Naranjo Adverse Drug Reaction scale and previous research suggest an association between pregabalin and rhabdomyolysis. Clinicians should be alert to the possibility of rhabdomyolysis occurring with the use of pregabalin, especially when taking statins.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327587","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}
Pelvic masses frequently originate from the pelvic cavity and are often associated with uterine, ovarian, or intestinal disorders. This report describes the case of a patient with a pelvic mass diagnosed as a retroperitoneal dermoid cyst at our hospital. We analyzed this case and conducted a literature review, to mitigate the risk of misdiagnosis and enhance the treatment of retroperitoneal masses.
{"title":"Retroperitoneal dermoid cyst complicated with uterine adenomyoma: a case report and literature review.","authors":"Yanhua Zhang, Hailing Liu, Wenjing Hou, Hui Cheng, Feng Wang, Lingyan Zhang, Jianbo Zhou, Feng Han, Weipei Zhu","doi":"10.1177/03000605241255810","DOIUrl":"10.1177/03000605241255810","url":null,"abstract":"<p><p>Pelvic masses frequently originate from the pelvic cavity and are often associated with uterine, ovarian, or intestinal disorders. This report describes the case of a patient with a pelvic mass diagnosed as a retroperitoneal dermoid cyst at our hospital. We analyzed this case and conducted a literature review, to mitigate the risk of misdiagnosis and enhance the treatment of retroperitoneal masses.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11185001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419496","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}
Pub Date : 2024-06-01DOI: 10.1177/03000605241258160
Yilong Hu, Junjie Ren, Zhixin Lv, He Liu, Xiewu Qiu
Objective: To assess the diagnostic value of C-reactive protein (CRP) and procalcitonin (PCT) for anastomotic leakage (AL) following colorectal surgery.
Methods: We retrospectively analyzed data for patients who underwent colorectal surgery at our hospital between November 2019 and December 2023. CRP and PCT were measured postoperatively to compare patients with/without AL, and changes were compared between low- and high-risk groups. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic accuracy of CRP and PCT to identify AL in high-risk patients.
Results: Mean CRP was 142.53 mg/L and 189.57 mg/L in the low- and high-risk groups, respectively, on postoperative day (POD)3. On POD2, mean PCT was 2.75 ng/mL and 8.16 ng/mL in low- and high-risk patients, respectively; values on POD3 were 3.53 ng/mL and 14.86 ng/mL, respectively. The areas under the curve (AUC) for CRP and PCT on POD3 were 0.71 and 0.78, respectively (CRP cut-off: 235.64 mg/L; sensitivity: 96%; specificity: 89.42% vs PCT cut-off: 3.94 ng/mL; sensitivity: 86%; specificity: 93.56%; AUC: 0.78). The AUC, sensitivity, and specificity for the combined diagnostic ability of CRP and PCT on POD3 were 0.92, 90%, and 100%, respectively (cut-off: 0.44).
Conclusions: Combining PCT and CRP on POD3 enhances the diagnostic accuracy for AL.
{"title":"Procalcitonin and C-reactive protein as early predictors in patients at high risk of colorectal anastomotic leakage.","authors":"Yilong Hu, Junjie Ren, Zhixin Lv, He Liu, Xiewu Qiu","doi":"10.1177/03000605241258160","DOIUrl":"10.1177/03000605241258160","url":null,"abstract":"<p><strong>Objective: </strong>To assess the diagnostic value of C-reactive protein (CRP) and procalcitonin (PCT) for anastomotic leakage (AL) following colorectal surgery.</p><p><strong>Methods: </strong>We retrospectively analyzed data for patients who underwent colorectal surgery at our hospital between November 2019 and December 2023. CRP and PCT were measured postoperatively to compare patients with/without AL, and changes were compared between low- and high-risk groups. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic accuracy of CRP and PCT to identify AL in high-risk patients.</p><p><strong>Results: </strong>Mean CRP was 142.53 mg/L and 189.57 mg/L in the low- and high-risk groups, respectively, on postoperative day (POD)3. On POD2, mean PCT was 2.75 ng/mL and 8.16 ng/mL in low- and high-risk patients, respectively; values on POD3 were 3.53 ng/mL and 14.86 ng/mL, respectively. The areas under the curve (AUC) for CRP and PCT on POD3 were 0.71 and 0.78, respectively (CRP cut-off: 235.64 mg/L; sensitivity: 96%; specificity: 89.42% vs PCT cut-off: 3.94 ng/mL; sensitivity: 86%; specificity: 93.56%; AUC: 0.78). The AUC, sensitivity, and specificity for the combined diagnostic ability of CRP and PCT on POD3 were 0.92, 90%, and 100%, respectively (cut-off: 0.44).</p><p><strong>Conclusions: </strong>Combining PCT and CRP on POD3 enhances the diagnostic accuracy for AL.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310899","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}
Pub Date : 2024-06-01DOI: 10.1177/03000605241261962
Li Tian, Hanfei Li, Xiufen Zhang, Linzi Liao, Juan Wu, Xiang Pei
Malignant hyperthermia (MH), characterized by severe myoclonus, pyrexia, tachycardia, hypertension, elevated muscle enzymes, and hypercapnia, often occurs in patients with congenital deformities or genetic disorders. Although the reported incidence rate is as low as 1:5000 to 1:100,000, patients with MH exhibit rapid aggravation and an elevated mortality rate. Thus, MH is associated with substantial perioperative risk. Successful treatment of patients with MH largely depends on early diagnosis and timely effective treatment. This clinical report provides a detailed description of a patient with newly diagnosed MH who developed a rapid rise in body temperature, end-tidal carbon dioxide, and heart rate during maxillary osteotomy. After successful rescue, the patient recovered smoothly during the postoperative period, indicating the importance of intraoperative monitoring, early diagnosis, effective treatment, and postoperative monitoring. This case is expected to serve as a reference for future interventions and healthcare practices in managing other patients with MH.
{"title":"Treatment and nursing care of a patient diagnosed with malignant hyperthermia after general anesthesia: a case report.","authors":"Li Tian, Hanfei Li, Xiufen Zhang, Linzi Liao, Juan Wu, Xiang Pei","doi":"10.1177/03000605241261962","DOIUrl":"10.1177/03000605241261962","url":null,"abstract":"<p><p>Malignant hyperthermia (MH), characterized by severe myoclonus, pyrexia, tachycardia, hypertension, elevated muscle enzymes, and hypercapnia, often occurs in patients with congenital deformities or genetic disorders. Although the reported incidence rate is as low as 1:5000 to 1:100,000, patients with MH exhibit rapid aggravation and an elevated mortality rate. Thus, MH is associated with substantial perioperative risk. Successful treatment of patients with MH largely depends on early diagnosis and timely effective treatment. This clinical report provides a detailed description of a patient with newly diagnosed MH who developed a rapid rise in body temperature, end-tidal carbon dioxide, and heart rate during maxillary osteotomy. After successful rescue, the patient recovered smoothly during the postoperative period, indicating the importance of intraoperative monitoring, early diagnosis, effective treatment, and postoperative monitoring. This case is expected to serve as a reference for future interventions and healthcare practices in managing other patients with MH.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11193925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437016","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}
Pub Date : 2024-06-01DOI: 10.1177/03000605241258474
Yoganiranjana Dharuman, Mirko Doss, Petar Risteski, Aron Frederik Popov
The gold standard therapy for end-stage heart failure is cardiac transplantation. However, in the face of a donor shortage, a mechanical assist device such as the left ventricular assist device HeartMate 3 (Abbott Laboratories, Abbott Park, IL, USA) serves as bridging therapy to transplantation and/or destination therapy. Current guidelines recommend anticoagulation with a vitamin K antagonist in combination with low-dose aspirin. We herein report a challenging anticoagulation regimen in a patient with a HeartMate 3 in whom systemic anticoagulation with warfarin was not feasible for 4 years because of low compatibility and a rare X-factor deficiency. This is a rare hematological disorder, estimated to affect approximately 1 in every 500,000 to 1,000,000 people in the general population. The patient finally received a modified anticoagulation regimen involving the combination of rivaroxaban and clopidogrel without warfarin. Under this regimen, the patient remained free of thromboembolic complications for 4 years with in situ placement of the left ventricular assist device. This case illustrates that under specific circumstances, long-term absence of warfarin therapy is feasible in patients with a HeartMate 3.
治疗终末期心力衰竭的金标准疗法是心脏移植。然而,在供体短缺的情况下,左心室辅助装置 HeartMate 3(雅培实验室,美国伊利诺伊州雅培公园)等机械辅助装置可作为移植和/或终点治疗的桥接疗法。现行指南建议使用维生素 K 拮抗剂联合小剂量阿司匹林进行抗凝治疗。我们在此报告了一个具有挑战性的抗凝治疗方案,患者患有 HeartMate 3,由于兼容性低和罕见的 X 因子缺乏症,4 年来一直无法使用华法林进行全身抗凝治疗。这是一种罕见的血液病,据估计在普通人群中约每 500,000 到 1,000,000 人中就有一人患有这种疾病。患者最终接受了一种改良的抗凝治疗方案,其中包括利伐沙班和氯吡格雷的组合,而不使用华法林。在这种治疗方案下,患者在原位放置左心室辅助装置的 4 年中一直没有出现血栓栓塞并发症。这个病例说明,在特定情况下,使用 HeartMate 3 的患者可以长期不用华法林治疗。
{"title":"Long-term discontinuation of warfarin in a patient with HeartMate 3 left ventricular assist device without thromboembolic events.","authors":"Yoganiranjana Dharuman, Mirko Doss, Petar Risteski, Aron Frederik Popov","doi":"10.1177/03000605241258474","DOIUrl":"10.1177/03000605241258474","url":null,"abstract":"<p><p>The gold standard therapy for end-stage heart failure is cardiac transplantation. However, in the face of a donor shortage, a mechanical assist device such as the left ventricular assist device HeartMate 3 (Abbott Laboratories, Abbott Park, IL, USA) serves as bridging therapy to transplantation and/or destination therapy. Current guidelines recommend anticoagulation with a vitamin K antagonist in combination with low-dose aspirin. We herein report a challenging anticoagulation regimen in a patient with a HeartMate 3 in whom systemic anticoagulation with warfarin was not feasible for 4 years because of low compatibility and a rare X-factor deficiency. This is a rare hematological disorder, estimated to affect approximately 1 in every 500,000 to 1,000,000 people in the general population. The patient finally received a modified anticoagulation regimen involving the combination of rivaroxaban and clopidogrel without warfarin. Under this regimen, the patient remained free of thromboembolic complications for 4 years with <i>in situ</i> placement of the left ventricular assist device. This case illustrates that under specific circumstances, long-term absence of warfarin therapy is feasible in patients with a HeartMate 3.</p>","PeriodicalId":16129,"journal":{"name":"Journal of International Medical Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432114","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}