Objective: Tension-type headache is the most common type of primary headache and results in a huge socioeconomic burden. This network meta-analysis (NMA) aimed to compare the efficacy and safety of simple analgesics for the treatment of episodic tension-type headache (ETTH) in adults.
Methods: We searched the Cochrane Library, PubMed, Web of Science, Embase, Chinese BioMedical Literature database and International Clinical Trials Registry Platform databases for eligible randomized clinical trials reporting the efficacy and/or safety of simple analgesics. A Bayesian NMA was performed to compare relative efficacy and safety. The surface under the cumulative ranking curve (SUCRA) was calculated to rank interventions. PROSPERO registration number: CRD42018090554.
Results: We highlighted six studies including 3507 patients. For the 2 h pain-free rate, the SUCRA ranking was ibuprofen > diclofenac-K > ketoprofen > acetaminophen > naproxen > placebo. All drugs except naproxen reported a higher 2 h pain-free rate than placebo, with a risk ratio (RR) of 2.86 (95% credible interval, CrI: 1.62-5.42) for ibuprofen and 2.61 (1.53-4.88) for diclofenac-K. For adverse events rate, the SUCRA ranking was: metamizol > diclofenac-K > ibuprofen > lumiracoxib > placebo > aspirin > acetaminophen > naproxen > ketoprofen. The adverse event rates of all analgesics were no higher than those of placebo, except for ketoprofen. Moreover, all drugs were superior to placebo in the global assessment of efficacy. In particular, the RR of lumiracoxib was 2.47 (1.57-4.57). Global heterogeneity I2 between the studies was low.
Conclusions: Simple analgesics are considered more effective and safe as a placebo for ETTH in adults. Our results suggest that ibuprofen and diclofenac-K may be the two best treatment options for patients with ETTH from a comprehensive point of view (both high-quality evidence).
{"title":"Efficacy and safety of simple analgesics for acute treatment of episodic tension-type headache in adults: a network meta-analysis.","authors":"Runsheng Xie, Jiahui Li, Yuyu Jing, Jinhui Tian, Hui Li, Yefeng Cai, Yangyang Wang, Wenjia Chen, Feilong Xu","doi":"10.1080/07853890.2024.2357235","DOIUrl":"10.1080/07853890.2024.2357235","url":null,"abstract":"<p><strong>Objective: </strong>Tension-type headache is the most common type of primary headache and results in a huge socioeconomic burden. This network meta-analysis (NMA) aimed to compare the efficacy and safety of simple analgesics for the treatment of episodic tension-type headache (ETTH) in adults.</p><p><strong>Methods: </strong>We searched the Cochrane Library, PubMed, Web of Science, Embase, Chinese BioMedical Literature database and International Clinical Trials Registry Platform databases for eligible randomized clinical trials reporting the efficacy and/or safety of simple analgesics. A Bayesian NMA was performed to compare relative efficacy and safety. The surface under the cumulative ranking curve (SUCRA) was calculated to rank interventions. PROSPERO registration number: CRD42018090554.</p><p><strong>Results: </strong>We highlighted six studies including 3507 patients. For the 2 h pain-free rate, the SUCRA ranking was ibuprofen > diclofenac-K > ketoprofen > acetaminophen > naproxen > placebo. All drugs except naproxen reported a higher 2 h pain-free rate than placebo, with a risk ratio (RR) of 2.86 (95% credible interval, CrI: 1.62-5.42) for ibuprofen and 2.61 (1.53-4.88) for diclofenac-K. For adverse events rate, the SUCRA ranking was: metamizol > diclofenac-K > ibuprofen > lumiracoxib > placebo > aspirin > acetaminophen > naproxen > ketoprofen. The adverse event rates of all analgesics were no higher than those of placebo, except for ketoprofen. Moreover, all drugs were superior to placebo in the global assessment of efficacy. In particular, the RR of lumiracoxib was 2.47 (1.57-4.57). Global heterogeneity <i>I</i><sup>2</sup> between the studies was low.</p><p><strong>Conclusions: </strong>Simple analgesics are considered more effective and safe as a placebo for ETTH in adults. Our results suggest that ibuprofen and diclofenac-K may be the two best treatment options for patients with ETTH from a comprehensive point of view (both high-quality evidence).</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11141314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141177071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-08-19DOI: 10.1080/07853890.2024.2392887
Till Johannes Bugaj, Tim Alexander Schwarz, Hans-Christoph Friederich, Christoph Nikendei
Introduction: Curiosity is a fundamental human trait that drives learning and exploration. However, research on curiosity has received little attention in the medical field, despite its potential to enhance knowledge acquisition, work performance, and psychosocial well-being. This study aimed to address part of this gap by investigating physicians' perspectives on their personal experiences with curiosity and its role in their professional practice and medical training.
Materials and methods: This qualitative study was conducted with 12 physicians from the University of Heidelberg Medical Hospital. Participants were contacted randomly via email and invited to participate in the study. Data were collected through semi-structured interviews between September 2019 and February 2020. The authors employed Mayring's approach, which denotes a qualitative content analysis method characterized by its systematic and rule-guided approach to analyzing textual data, aiming to extract meaningful insights and patterns or themes. The identified themes were linked to overall categories to draw conclusions from the data.
Results: The interviewees highlighted three main areas regarding curiosity's importance [1]: as a driving force for (lifelong) education [2], in building empathetic physician-patient relationships, and [3] as a core quality of a good researcher. They primarily linked curiosity with positive emotions, while the non-expression of curiosity was associated with dissatisfaction, boredom, and exhaustion. Factors such as heavy workloads, time constraints, stress, and lack of autonomy inhibit their curiosity, while varied activities, professional exchange with colleagues, and exposure to new challenges foster it. Physicians' perspectives on the link between burnout and curiosity were not consistent. Interestingly, some viewed curiosity as protective against burnout, while others saw excessive curiosity as a potential source of frustration and burnout.
Conclusion: This study represents the first attempt to explore physicians' perspectives on curiosity in medicine. The findings highlight the potential importance of curiosity in shaping medical professionalism and improving patient care. However, its pursuit is hampered by the challenging working conditions faced by doctors, suggesting a need for enhanced support and cultivation.
{"title":"The curious physician: exploring the role of curiosity in professionalism, patient care, and well-being.","authors":"Till Johannes Bugaj, Tim Alexander Schwarz, Hans-Christoph Friederich, Christoph Nikendei","doi":"10.1080/07853890.2024.2392887","DOIUrl":"10.1080/07853890.2024.2392887","url":null,"abstract":"<p><strong>Introduction: </strong>Curiosity is a fundamental human trait that drives learning and exploration. However, research on curiosity has received little attention in the medical field, despite its potential to enhance knowledge acquisition, work performance, and psychosocial well-being. This study aimed to address part of this gap by investigating physicians' perspectives on their personal experiences with curiosity and its role in their professional practice and medical training.</p><p><strong>Materials and methods: </strong>This qualitative study was conducted with 12 physicians from the University of Heidelberg Medical Hospital. Participants were contacted randomly <i>via</i> email and invited to participate in the study. Data were collected through semi-structured interviews between September 2019 and February 2020. The authors employed Mayring's approach, which denotes a qualitative content analysis method characterized by its systematic and rule-guided approach to analyzing textual data, aiming to extract meaningful insights and patterns or themes. The identified themes were linked to overall categories to draw conclusions from the data.</p><p><strong>Results: </strong>The interviewees highlighted three main areas regarding curiosity's importance [1]: as a driving force for (lifelong) education [2], in building empathetic physician-patient relationships, and [3] as a core quality of a good researcher. They primarily linked curiosity with positive emotions, while the non-expression of curiosity was associated with dissatisfaction, boredom, and exhaustion. Factors such as heavy workloads, time constraints, stress, and lack of autonomy inhibit their curiosity, while varied activities, professional exchange with colleagues, and exposure to new challenges foster it. Physicians' perspectives on the link between burnout and curiosity were not consistent. Interestingly, some viewed curiosity as protective against burnout, while others saw excessive curiosity as a potential source of frustration and burnout.</p><p><strong>Conclusion: </strong>This study represents the first attempt to explore physicians' perspectives on curiosity in medicine. The findings highlight the potential importance of curiosity in shaping medical professionalism and improving patient care. However, its pursuit is hampered by the challenging working conditions faced by doctors, suggesting a need for enhanced support and cultivation.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11334747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The associations between multiple sleep characteristics and smoking behavior are inconsistent, and it is unclear which sleep characteristics are most crucial for tobacco prevention. This study aimed to explore the associations between smoking status/intensity and multiple sleep characteristics and to identify the potential core domain of smoking-related sleep using network analysis. Data were obtained from a survey of cancer-related risk factors among Chinese adults. Logistic regression models were used to quantify the associations between sleep characteristics and smoking status/intensity. Network analyses were employed to identify the core sleep characteristics. A total of 5,228 participants with a median age of 44 years old were included in the study. Current smoking was significantly positively associated with long nap time, difficulty falling asleep, late bedtime, getting up after 7 am, and waking up earlier than expected. There was significant positive association between current smoking and short sleep duration in young adults under 45 years old. Late bedtime and getting up after 7 am were only associated with current heavy smoking, but not current light smoking. Network analyses showed that multiple smoking-related sleep characteristics were interconnected, with difficulty falling asleep and late bedtime as central characteristics in the network. The study found that the associations between sleep characteristics and smoking varied by age and smoking intensity and highlights the potential benefits of sleep health promotion in smoking cessation, with a particular focus on difficulty falling asleep and late bedtime.
{"title":"Network analysis of smoking-related sleep characteristics in Chinese adults.","authors":"Yuting Xie, Peiyuan Sun, Huang Huang, Jianjun Wu, Yue Ba, Guoyu Zhou, Fangfang Yu, Daming Zhang, Yaqun Zhang, Ranran Qie, Zhuolun Hu, Kaiyong Zou, Yawei Zhang","doi":"10.1080/07853890.2024.2332424","DOIUrl":"10.1080/07853890.2024.2332424","url":null,"abstract":"<p><p>The associations between multiple sleep characteristics and smoking behavior are inconsistent, and it is unclear which sleep characteristics are most crucial for tobacco prevention. This study aimed to explore the associations between smoking status/intensity and multiple sleep characteristics and to identify the potential core domain of smoking-related sleep using network analysis. Data were obtained from a survey of cancer-related risk factors among Chinese adults. Logistic regression models were used to quantify the associations between sleep characteristics and smoking status/intensity. Network analyses were employed to identify the core sleep characteristics. A total of 5,228 participants with a median age of 44 years old were included in the study. Current smoking was significantly positively associated with long nap time, difficulty falling asleep, late bedtime, getting up after 7 am, and waking up earlier than expected. There was significant positive association between current smoking and short sleep duration in young adults under 45 years old. Late bedtime and getting up after 7 am were only associated with current heavy smoking, but not current light smoking. Network analyses showed that multiple smoking-related sleep characteristics were interconnected, with difficulty falling asleep and late bedtime as central characteristics in the network. The study found that the associations between sleep characteristics and smoking varied by age and smoking intensity and highlights the potential benefits of sleep health promotion in smoking cessation, with a particular focus on difficulty falling asleep and late bedtime.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10964831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Human metapneumovirus (HMPV) is a common respiratory pathogen that causes respiratory tract infections. In India, HMPV has been identified as one of the leading causes of morbidity and mortality in infants and young children with respiratory tract infections. The most reported sublineages of HMPV in India are B1, B2, A2b and A2c.
Objective: A retrospective study was conducted to determine the circulating genotypes of HMPV among SARI cases from January 2016 to December 2018.
Materials and methods: Positive throat swab samples were confirmed with real-time RT-PCR. Subsequently, these samples were analysed using semi-nested conventional RT-PCR targeting the G gene, followed by sequencing and phylogenetic analysis. Clinical data analysis was also performed using SPSS 15.0 software.
Results: All 20 samples from the SARI cases were classified under the A2c sublineage of HMPV. Phylogenetic analysis indicated that these strains were genetically related to those circulating in Japan, China, and Croatia. Among the samples, ten showed 111-nucleotide duplications, while the other ten had 180-nucleotide duplications.
Conclusion: Clinical analysis showed that four cases had coinfections with other pathogens. Our extensive analysis of patient samples determined that HMPV, especially the A2c genotype, significantly contributed to SARI cases within our study population, which signifies the importance of considering HMPV as a probable aetiological agent when investigating SARI outbreaks.
{"title":"Molecular detection and genotyping of HMPV in patients with severe acute respiratory infection in India.","authors":"Pragathi P, Ujwal Shetty, Preetiparna Parida, Prasad Varamballi, Chiranjay Mukhopadhyay, Sudheesh N","doi":"10.1080/07853890.2024.2398719","DOIUrl":"10.1080/07853890.2024.2398719","url":null,"abstract":"<p><strong>Background: </strong>Human metapneumovirus (HMPV) is a common respiratory pathogen that causes respiratory tract infections. In India, HMPV has been identified as one of the leading causes of morbidity and mortality in infants and young children with respiratory tract infections. The most reported sublineages of HMPV in India are B1, B2, A2b and A2c.</p><p><strong>Objective: </strong>A retrospective study was conducted to determine the circulating genotypes of HMPV among SARI cases from January 2016 to December 2018.</p><p><strong>Materials and methods: </strong>Positive throat swab samples were confirmed with real-time RT-PCR. Subsequently, these samples were analysed using semi-nested conventional RT-PCR targeting the G gene, followed by sequencing and phylogenetic analysis. Clinical data analysis was also performed using SPSS 15.0 software.</p><p><strong>Results: </strong>All 20 samples from the SARI cases were classified under the A2c sublineage of HMPV. Phylogenetic analysis indicated that these strains were genetically related to those circulating in Japan, China, and Croatia. Among the samples, ten showed 111-nucleotide duplications, while the other ten had 180-nucleotide duplications.</p><p><strong>Conclusion: </strong>Clinical analysis showed that four cases had coinfections with other pathogens. Our extensive analysis of patient samples determined that HMPV, especially the A2c genotype, significantly contributed to SARI cases within our study population, which signifies the importance of considering HMPV as a probable aetiological agent when investigating SARI outbreaks.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-08-28DOI: 10.1080/07853890.2024.2396072
Haixu Zhao, Ying Yao, Ce Zong, Hongbing Liu, Ke Zhang, Yuan Song, Beizhu Ye, Jing Yang, Yusheng Li, Bo Song, Yuming Xu, Yuan Gao
Background: Serum fibrinogen/albumin ratio (FAR) is a new inflammatory marker related to a variety of diseases, and it has been shown to be associated with stroke. This study is to investigate the relationship between serum FAR and early neurological deterioration (END) in patients with recent small subcortical infarction (RSSI).
Patients and methods: Consecutive RSSI patients admitted to the First Affiliated Hospital of Zhengzhou University from June 2015 to June 2022 were enrolled. The National Institute of Health Stroke Scale (NIHSS) was utilized to evaluate the severity of the patients at admission and within seven days post-admission. END was defined as an increase of ≥2 points in NIHSS score from admission or ≥1 point in the motor item of the score within seven days post-admission. Multivariate logistic regression analysis was employed to identify risk factors for END. The correlation between FAR and END was investigated using restricted cubic spline (RCS) analysis. Subgroup analysis was used to assess stability across different populations.
Results: A total of 766 RSSI patients were included in the analysis, with 538 males (70.24%). END occurred in 115 (15.01%) patients. Multivariate logistic regression analysis revealed that FAR (OR = 1.016, 95%CI: 1.005-1.028), PAD (OR = 1.805, 95%CI: 1.161-2.807) and age (OR = 1.028, 95%CI: 1.009-1.048) were associated with END in RSSI patients. RCS analysis indicated a linear correlation between FAR and END (p for nonlinear = .128). Subgroup analysis indicated association between FAR and END in male (OR = 1.02, 95%CI: 1.00-1.03), patients aged ≤65 years (OR = 1.02, 95%CI: 1.00-1.03) and patients without smoking history (OR = 1.02, 95%CI: 1.00-1.03).
Conclusions: Elevated FAR levels were associated with the occurrence of END within seven days after admission in RSSI patients, especially in men, age ≤65 years, or patients without smoking history.
{"title":"Serum fibrinogen/albumin ratio and early neurological deterioration in patients with recent small subcortical infarction.","authors":"Haixu Zhao, Ying Yao, Ce Zong, Hongbing Liu, Ke Zhang, Yuan Song, Beizhu Ye, Jing Yang, Yusheng Li, Bo Song, Yuming Xu, Yuan Gao","doi":"10.1080/07853890.2024.2396072","DOIUrl":"10.1080/07853890.2024.2396072","url":null,"abstract":"<p><strong>Background: </strong>Serum fibrinogen/albumin ratio (FAR) is a new inflammatory marker related to a variety of diseases, and it has been shown to be associated with stroke. This study is to investigate the relationship between serum FAR and early neurological deterioration (END) in patients with recent small subcortical infarction (RSSI).</p><p><strong>Patients and methods: </strong>Consecutive RSSI patients admitted to the First Affiliated Hospital of Zhengzhou University from June 2015 to June 2022 were enrolled. The National Institute of Health Stroke Scale (NIHSS) was utilized to evaluate the severity of the patients at admission and within seven days post-admission. END was defined as an increase of ≥2 points in NIHSS score from admission or ≥1 point in the motor item of the score within seven days post-admission. Multivariate logistic regression analysis was employed to identify risk factors for END. The correlation between FAR and END was investigated using restricted cubic spline (RCS) analysis. Subgroup analysis was used to assess stability across different populations.</p><p><strong>Results: </strong>A total of 766 RSSI patients were included in the analysis, with 538 males (70.24%). END occurred in 115 (15.01%) patients. Multivariate logistic regression analysis revealed that FAR (OR = 1.016, 95%CI: 1.005-1.028), PAD (OR = 1.805, 95%CI: 1.161-2.807) and age (OR = 1.028, 95%CI: 1.009-1.048) were associated with END in RSSI patients. RCS analysis indicated a linear correlation between FAR and END (<i>p</i> for nonlinear = .128). Subgroup analysis indicated association between FAR and END in male (OR = 1.02, 95%CI: 1.00-1.03), patients aged ≤65 years (OR = 1.02, 95%CI: 1.00-1.03) and patients without smoking history (OR = 1.02, 95%CI: 1.00-1.03).</p><p><strong>Conclusions: </strong>Elevated FAR levels were associated with the occurrence of END within seven days after admission in RSSI patients, especially in men, age ≤65 years, or patients without smoking history.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11360646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The burden of carbapenem-resistant gram-negative bacteria (CRGNB) among solid organ transplant (SOT) recipients has not been systematically explored. Here, we discern the risk factors associated with CRGNB infection and colonization in SOT recipients.
Methods: This study included observational studies conducted among CRGNB-infected SOT patients, which reported risk factors associated with mortality, infection or colonization. Relevant records will be searched in PubMed, Embase and Web of Science for the period from the time of database construction to 1 March 2023.
Results: A total of 23 studies with 13,511 participants were included, enabling the assessment of 27 potential risk factors. The pooled prevalence of 1-year mortality among SOT recipients with CRGNB was 44.5%. Prolonged mechanical ventilation, combined transplantation, reoperation and pre-transplantation CRGNB colonization are salient contributors to the occurrence of CRGNB infections in SOT recipients. Renal replacement therapy, post-LT CRGNB colonization, pre-LT liver disease and model for end-stage liver disease score increased the risk of infection. Re-transplantation, carbapenem use before transplantation and ureteral stent utilization increaesd risk of CRGNB colonization.
Conclusion: Our study demonstrated that SOT recipients with CRGNB infections had a higher mortality risk. Invasive procedure may be the main factor contribute to CRGNB infection.
背景:目前尚未对实体器官移植(SOT)受者中耐碳青霉烯类革兰氏阴性菌(CRGNB)的负担进行系统研究。在此,我们探讨了与 SOT 受者中 CRGNB 感染和定植相关的风险因素:本研究纳入了在感染 CRGNB 的 SOT 患者中开展的观察性研究,这些研究报告了与死亡率、感染或定植相关的风险因素。相关记录将在 PubMed、Embase 和 Web of Science 中进行检索,检索时间为数据库建立后至 2023 年 3 月 1 日:结果:共纳入 23 项研究,13,511 名参与者,对 27 个潜在风险因素进行了评估。合并 CRGNB 的 SOT 受者 1 年死亡率为 44.5%。长期机械通气、联合移植、再次手术和移植前CRGNB定植是导致SOT受者发生CRGNB感染的主要因素。肾脏替代治疗、移植后 CRGNB 定植、移植前肝脏疾病和终末期肝病模型评分增加了感染风险。再次移植、移植前使用碳青霉烯类抗生素和使用输尿管支架增加了CRGNB定植的风险:我们的研究表明,感染 CRGNB 的 SOT 受者死亡率较高。侵入性手术可能是导致 CRGNB 感染的主要因素。
{"title":"A comprehensive evaluation of risk factors for mortality, infection and colonization associated with CRGNB in adult solid organ transplant recipients: a systematic review and meta-analysis.","authors":"Siyu Gao, Xiaoli Huang, Xiaolin Zhou, Xiangcheng Dai, Jing Han, Yandong Chen, Hongliang Qiao, Yi Li, Yifan Zhou, Ting Wang, Huiqing He, Qiang Liu, Shenjie Tang","doi":"10.1080/07853890.2024.2314236","DOIUrl":"10.1080/07853890.2024.2314236","url":null,"abstract":"<p><strong>Background: </strong>The burden of carbapenem-resistant gram-negative bacteria (CRGNB) among solid organ transplant (SOT) recipients has not been systematically explored. Here, we discern the risk factors associated with CRGNB infection and colonization in SOT recipients.</p><p><strong>Methods: </strong>This study included observational studies conducted among CRGNB-infected SOT patients, which reported risk factors associated with mortality, infection or colonization. Relevant records will be searched in PubMed, Embase and Web of Science for the period from the time of database construction to 1 March 2023.</p><p><strong>Results: </strong>A total of 23 studies with 13,511 participants were included, enabling the assessment of 27 potential risk factors. The pooled prevalence of 1-year mortality among SOT recipients with CRGNB was 44.5%. Prolonged mechanical ventilation, combined transplantation, reoperation and pre-transplantation CRGNB colonization are salient contributors to the occurrence of CRGNB infections in SOT recipients. Renal replacement therapy, post-LT CRGNB colonization, pre-LT liver disease and model for end-stage liver disease score increased the risk of infection. Re-transplantation, carbapenem use before transplantation and ureteral stent utilization increaesd risk of CRGNB colonization.</p><p><strong>Conclusion: </strong>Our study demonstrated that SOT recipients with CRGNB infections had a higher mortality risk. Invasive procedure may be the main factor contribute to CRGNB infection.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: Esophageal squamous cell carcinoma (ESCC) is a malignant tumor with high incidence and mortality rates worldwide. This study aimed to investigate the correlation between LINC-PINT polymorphisms and ESCC risk in the Hainan Han population.
Methods: A total of 391 patients with ESCC and 452 healthy controls were enrolled to evaluate the effect of LINC-PINT SNPs (single nucleotide polymorphisms) on ESCC susceptibility. Associations were evaluated by calculating odds ratios (OR) and 95% confidence intervals (CIs). Multifactor dimensionality reduction analysis was performed to explore the association between SNP-SNP interactions and ESCC susceptibility. We further determined the correlation between clinical indicators and SNP in patients with ESCC.
Results: Our study showed that rs157916 (OR 0.63, p = 0.011) and rs157928 (OR 0.80, p = 0.021) were associated with a decreased risk of ESCC. Stratified analysis indicated that rs157916 could decrease the risk of ESCC in people aged >64 years, in males, and non-drinkers (OR 0.58, p = 0.042; OR 0.58, p = 0.010; OR 0.62, p = 0.025, respectively). Rs16873842 was related to a decreased risk of ESCC in males (OR 0.70, p = 0.015). Rs7801029 was associated with ESCC risk in females (OR 0.39, p = 0.033) and non-drinkers (OR 0.68, p = 0.040). Rs7781295 decreased the ESCC risk in smokers (OR 0.58, p = 0.046) and drinkers (OR 0.58, p = 0.046). In addition, rs157928 played a protective role in ESCC risk in females (OR 0.39, p = 0.033) and non-smokers (OR 0.32, p = 0.006). Additionally, the best predictive model for ESCC was a combination of rs157916, rs16873842, rs7801029, rs7781295, rs28662387, and rs157928.
Conclusion: Our study revealed that LINC-PINT polymorphisms were associated with ESCC risk.
{"title":"Assessment of <i>LINC-PINT</i> genetic polymorphisms and esophageal squamous cell carcinoma risk in the Hainan Han population.","authors":"Ruisha Tu, Dunjing Zhong, Ping Li, Yongyu Li, Zhuang Chen, Feixiang Hu, Guihong Yuan, Zhaowei Chen, Shuyong Yu, Jian Song","doi":"10.1080/07853890.2024.2397569","DOIUrl":"10.1080/07853890.2024.2397569","url":null,"abstract":"<p><strong>Objectives: </strong>Esophageal squamous cell carcinoma (ESCC) is a malignant tumor with high incidence and mortality rates worldwide. This study aimed to investigate the correlation between <i>LINC-PINT</i> polymorphisms and ESCC risk in the Hainan Han population.</p><p><strong>Methods: </strong>A total of 391 patients with ESCC and 452 healthy controls were enrolled to evaluate the effect of <i>LINC-PINT</i> SNPs (single nucleotide polymorphisms) on ESCC susceptibility. Associations were evaluated by calculating odds ratios (OR) and 95% confidence intervals (CIs). Multifactor dimensionality reduction analysis was performed to explore the association between SNP-SNP interactions and ESCC susceptibility. We further determined the correlation between clinical indicators and SNP in patients with ESCC.</p><p><strong>Results: </strong>Our study showed that rs157916 (OR 0.63, <i>p</i> = 0.011) and rs157928 (OR 0.80, <i>p</i> = 0.021) were associated with a decreased risk of ESCC. Stratified analysis indicated that rs157916 could decrease the risk of ESCC in people aged >64 years, in males, and non-drinkers (OR 0.58, <i>p</i> = 0.042; OR 0.58, <i>p</i> = 0.010; OR 0.62, <i>p</i> = 0.025, respectively). Rs16873842 was related to a decreased risk of ESCC in males (OR 0.70, <i>p</i> = 0.015). Rs7801029 was associated with ESCC risk in females (OR 0.39, <i>p</i> = 0.033) and non-drinkers (OR 0.68, <i>p</i> = 0.040). Rs7781295 decreased the ESCC risk in smokers (OR 0.58, <i>p</i> = 0.046) and drinkers (OR 0.58, <i>p</i> = 0.046). In addition, rs157928 played a protective role in ESCC risk in females (OR 0.39, <i>p</i> = 0.033) and non-smokers (OR 0.32, <i>p</i> = 0.006). Additionally, the best predictive model for ESCC was a combination of rs157916, rs16873842, rs7801029, rs7781295, rs28662387, and rs157928.</p><p><strong>Conclusion: </strong>Our study revealed that <i>LINC-PINT</i> polymorphisms were associated with ESCC risk.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-02-02DOI: 10.1080/07853890.2024.2311227
Xiyi Wang, Dandan Chen, Ping Zou, Hui Zhang, Xunhan Qiu, Li Xu, Geraldine Lee
Background: While Cardiac Rehabilitation (CR) programs have shown effectiveness in improving cardiac outcomes, there is limited understanding of how patients perceive and adapt to these interventions. Furthermore, alternative modes of delivering CR that have received positive evaluations from participants remain underexplored, yet they have the potential to enhance CR uptake.
Objectives: To explore the patient experience in CR programmes following Acute Myocardial Infarction (AMI) and describe their adaptive processing.
Patients and methods: This qualitative study was conducted at a nationally certified centre in China between July 2021 and September 2022, encompassing three stages: in-hospital, centre-based, and home-based CR programs. Purposive sampling was used to select eligible AMI patients for in-depth semi-structured interviews. The interview outline and analytical framework were aligned with the key concepts derived from the middle-range theory of adaptation to chronic illness and the normalization process theory. The findings were reported following the Consolidated Criteria for Reporting Qualitative Research checklist.
Results: Forty AMI patients were recruited. Four main themes describing the process of AMI patients normalizing CR intervention were identified, including (1) experiencing CR service driving by role's responsibilities, (2) engaging in collaborative relationship based on interpersonal trust, (3) exploring a personalized rehabilitation plan by complex integration, and (4) expecting a promised outcome to shape decision-making.
Conclusion: Integrated care interventions for AMI patients could benefit from a collaborative co-designed approach to ensure that CR interventions are normalized and fit into patients' daily lives. Organizational-level CR services should align with the rehabilitation needs and expectations of patients.
背景:虽然心脏康复(CR)计划在改善心脏预后方面显示出了有效性,但人们对患者如何看待和适应这些干预措施的了解却很有限。此外,获得参与者积极评价的其他心脏康复模式仍未得到充分探索,但这些模式有可能提高心脏康复的接受率:探索急性心肌梗死(AMI)后患者在 CR 项目中的体验,并描述他们的适应性处理过程:这项定性研究于2021年7月至2022年9月在中国一家国家认证中心进行,包括三个阶段:院内、中心和家庭CR项目。研究采用了有目的的抽样方法,选择符合条件的急性心肌梗死患者进行深入的半结构化访谈。访谈提纲和分析框架与慢性病适应中程理论和正常化过程理论中的关键概念相一致。研究结果按照定性研究报告综合标准清单进行报告:共招募了 40 名急性心肌梗死患者。结果:招募了 40 名 AMI 患者,确定了描述 AMI 患者 CR 干预正常化过程的四个主要主题,包括(1)体验由角色责任驱动的 CR 服务;(2)参与基于人际信任的合作关系;(3)通过复杂的整合探索个性化的康复计划;以及(4)期待承诺的结果以形成决策:针对急性心肌梗死患者的综合护理干预可受益于合作共同设计的方法,以确保 CR 干预正常化并融入患者的日常生活。组织层面的 CR 服务应符合患者的康复需求和期望。
{"title":"Understanding adaptive tasks in cardiac rehabilitation among patients with acute myocardial infarction: a qualitative study.","authors":"Xiyi Wang, Dandan Chen, Ping Zou, Hui Zhang, Xunhan Qiu, Li Xu, Geraldine Lee","doi":"10.1080/07853890.2024.2311227","DOIUrl":"10.1080/07853890.2024.2311227","url":null,"abstract":"<p><strong>Background: </strong>While Cardiac Rehabilitation (CR) programs have shown effectiveness in improving cardiac outcomes, there is limited understanding of how patients perceive and adapt to these interventions. Furthermore, alternative modes of delivering CR that have received positive evaluations from participants remain underexplored, yet they have the potential to enhance CR uptake.</p><p><strong>Objectives: </strong>To explore the patient experience in CR programmes following Acute Myocardial Infarction (AMI) and describe their adaptive processing.</p><p><strong>Patients and methods: </strong>This qualitative study was conducted at a nationally certified centre in China between July 2021 and September 2022, encompassing three stages: in-hospital, centre-based, and home-based CR programs. Purposive sampling was used to select eligible AMI patients for in-depth semi-structured interviews. The interview outline and analytical framework were aligned with the key concepts derived from the middle-range theory of adaptation to chronic illness and the normalization process theory. The findings were reported following the Consolidated Criteria for Reporting Qualitative Research checklist.</p><p><strong>Results: </strong>Forty AMI patients were recruited. Four main themes describing the process of AMI patients normalizing CR intervention were identified, including (1) experiencing CR service driving by role's responsibilities, (2) engaging in collaborative relationship based on interpersonal trust, (3) exploring a personalized rehabilitation plan by complex integration, and (4) expecting a promised outcome to shape decision-making.</p><p><strong>Conclusion: </strong>Integrated care interventions for AMI patients could benefit from a collaborative co-designed approach to ensure that CR interventions are normalized and fit into patients' daily lives. Organizational-level CR services should align with the rehabilitation needs and expectations of patients.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10840589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139673820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The effectiveness of nirmatrelvir-ritonavir has mainly been shown in non-hospitalized patients with mild-to-moderate coronavirus disease 2019 (COVID-19). The real-world effectiveness of nirmatrelvir-ritonavir urgently needs to be determined using representative in-hospital patients with COVID-19 during the Omicron wave of the pandemic.
Methods: We performed a multicentre, retrospective study in five Chinese PLA General Hospital medical centers in Beijing, China. Patients hospitalized with COVID-19 from 10 December 2022 to 20 February 2023 were eligible for inclusion. A 1:1 propensity score matching was performed between the nirmatrelvir-ritonavir group and the control group.
Results: 1010 recipients of nirmatrelvir-ritonavir and 1010 matched controls were finally analyzed after matching. Compared with matched controls, the nirmatrelvir-ritonavir group had a lower incidence rate of all-cause death (4.6/1000 vs. 6.3/1000 person-days, p = 0.013) and a higher incidence rate of clinical improvement (47.6/1000 vs. 45.8/1000 person-days, p = 0.012). Nirmatrelvir-ritonavir was associated with a 22% lower all-cause mortality and a 14% higher incidence of clinical improvement. Initiation of nirmatrelvir-ritonavir within 5 days after symptom onset was associated with a 50% lower mortality and a 26% higher clinical improvement rate. By contrast, no significant associations were identified among patients receiving nirmatrelvir-ritonavir treatment more than 5 days after symptom onset. Nirmatrelvir-ritonavir was also associated with a 50% increase in survival days and a 12% decrease in days to clinical improvement.
Conclusion: Among hospitalized patients with COVID-19 during the Omicron wave in Beijing, China, the early initiation of nirmatrelvir-ritonavir was associated with clinical benefits of lowering mortality and improving clinical recovery.
{"title":"Associations of nirmatrelvir-ritonavir treatment with death and clinical improvement in hospitalized patients with COVID-19 during the Omicron wave in Beijing, China: a multicentre, retrospective cohort study.","authors":"Xiaobo Han, Chenglong Li, Xin Yuan, Junchang Cui, Zhihai Han, Jiguang Meng, Weiguo Zhao, Fei Xie, Kaifei Wang, Yuhong Liu, Guoxin Muo, Na Xi, Mengli Zheng, Rentao Wang, Kun Xiao, Wei Chen, Junchen Xiong, Dahui Zhao, Xinxin Zhang, Xinjie Han, Haibo Cheng, Zhongkuo Yu, Yinghan Shi, Wuxiang Xie, Lixin Xie","doi":"10.1080/07853890.2024.2313062","DOIUrl":"10.1080/07853890.2024.2313062","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of nirmatrelvir-ritonavir has mainly been shown in non-hospitalized patients with mild-to-moderate coronavirus disease 2019 (COVID-19). The real-world effectiveness of nirmatrelvir-ritonavir urgently needs to be determined using representative in-hospital patients with COVID-19 during the Omicron wave of the pandemic.</p><p><strong>Methods: </strong>We performed a multicentre, retrospective study in five Chinese PLA General Hospital medical centers in Beijing, China. Patients hospitalized with COVID-19 from 10 December 2022 to 20 February 2023 were eligible for inclusion. A 1:1 propensity score matching was performed between the nirmatrelvir-ritonavir group and the control group.</p><p><strong>Results: </strong>1010 recipients of nirmatrelvir-ritonavir and 1010 matched controls were finally analyzed after matching. Compared with matched controls, the nirmatrelvir-ritonavir group had a lower incidence rate of all-cause death (4.6/1000 vs. 6.3/1000 person-days, <i>p</i> = 0.013) and a higher incidence rate of clinical improvement (47.6/1000 vs. 45.8/1000 person-days, <i>p</i> = 0.012). Nirmatrelvir-ritonavir was associated with a 22% lower all-cause mortality and a 14% higher incidence of clinical improvement. Initiation of nirmatrelvir-ritonavir within 5 days after symptom onset was associated with a 50% lower mortality and a 26% higher clinical improvement rate. By contrast, no significant associations were identified among patients receiving nirmatrelvir-ritonavir treatment more than 5 days after symptom onset. Nirmatrelvir-ritonavir was also associated with a 50% increase in survival days and a 12% decrease in days to clinical improvement.</p><p><strong>Conclusion: </strong>Among hospitalized patients with COVID-19 during the Omicron wave in Beijing, China, the early initiation of nirmatrelvir-ritonavir was associated with clinical benefits of lowering mortality and improving clinical recovery.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10868413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-02-05DOI: 10.1080/07853890.2023.2297273
Carlo Volf, Paul Michael Petersen, Anders Thorseth, Stefan Vestergaard, Klaus Martiny
Introduction: This study investigated the health effects of two different architectural glass types: A two-layered low-iron high transmittance glass and a three-layered low energy glass with lower transmittance. The study investigated how these glass types affected daylight conditions in 72 residential apartments, as well as health and satisfaction of the residents.Methods: The study installed high transmittance glass (light transmittance LT:0.82) in 36 apartments and low transmittance (LT:0.74) in 36 identical apartments. The study then analyzed the light transmittance of each glass type in the laboratory and analyzed the indoor environmental quality (IEQ) in eight representative apartments before and after renovation. Self-reported questionnaires were handed out and collected before and after renovation.Results: The results showed that the glass types differed significantly in measured daylight transmittance. The two-layered high transmittance glass transmitted 15% more visual light (380-750 nm) and 20% more light in the spectral range (460-480 nm), stimulating ipRGCs and circadian rhythm, when compared to three-layered low energy glass. In addition, significant differences were observed in the UV-B spectrum (280-315 nm). While two-layered high transmittance glass transmitted UV-B, three-layered low transmittance glass did not. During the 12-month study period, residents in apartments with three-layered low energy glass reported more difficulties sleeping (p = 0.05), higher satisfaction with daylight (p = 0.03) and higher satisfaction with ventilation (p = 0.04). Residents in apartments with three-layered low energy glass experienced fewer days with too cold indoor temperatures (p = 0.02), compared to residents with two-layered low-iron glass. The results of energy consumption for heating showed that two-layered low-iron glass reduced the energy consumption by 11.0%, while three-layered low energy glass reduced the energy consumption by 9.4%, compared to the year prior to renovation.Conclusion: The results contribute to a discussion about potential energy savings on one hand and potential non-energy benefits, such as daylight quality, overall health, and total economy/life cycle assessment of the built environment on the other hand. The results suggest further research performed in randomized large-scale studies.
{"title":"Daylight quality: high-transmittance glass versus low transmittance glass - effects on daylight quality, health, comfort and energy consumption.","authors":"Carlo Volf, Paul Michael Petersen, Anders Thorseth, Stefan Vestergaard, Klaus Martiny","doi":"10.1080/07853890.2023.2297273","DOIUrl":"10.1080/07853890.2023.2297273","url":null,"abstract":"<p><p><b>Introduction:</b> This study investigated the health effects of two different architectural glass types: A two-layered low-iron high transmittance glass and a three-layered low energy glass with lower transmittance. The study investigated how these glass types affected daylight conditions in 72 residential apartments, as well as health and satisfaction of the residents.<b>Methods:</b> The study installed high transmittance glass (light transmittance LT:0.82) in 36 apartments and low transmittance (LT:0.74) in 36 identical apartments. The study then analyzed the light transmittance of each glass type in the laboratory and analyzed the indoor environmental quality (IEQ) in eight representative apartments before and after renovation. Self-reported questionnaires were handed out and collected before and after renovation.<b>Results:</b> The results showed that the glass types differed significantly in measured daylight transmittance. The two-layered high transmittance glass transmitted 15% more visual light (380-750 nm) and 20% more light in the spectral range (460-480 nm), stimulating ipRGCs and circadian rhythm, when compared to three-layered low energy glass. In addition, significant differences were observed in the UV-B spectrum (280-315 nm). While two-layered high transmittance glass transmitted UV-B, three-layered low transmittance glass did not. During the 12-month study period, residents in apartments with three-layered low energy glass reported more difficulties sleeping (<i>p</i> = 0.05), higher satisfaction with daylight (<i>p</i> = 0.03) and higher satisfaction with ventilation (<i>p</i> = 0.04). Residents in apartments with three-layered low energy glass experienced fewer days with too cold indoor temperatures (<i>p</i> = 0.02), compared to residents with two-layered low-iron glass. The results of energy consumption for heating showed that two-layered low-iron glass reduced the energy consumption by 11.0%, while three-layered low energy glass reduced the energy consumption by 9.4%, compared to the year prior to renovation.<b>Conclusion:</b> The results contribute to a discussion about potential energy savings on one hand and potential non-energy benefits, such as daylight quality, overall health, and total economy/life cycle assessment of the built environment on the other hand. The results suggest further research performed in randomized large-scale studies.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10846434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}