This article reviews the evidence for efficacy and safety of Saccharomyces boulardii(S.boulardii) for various disease indications in adults based on the peerreviewed,randomized clinical trials and pre-clinical studies...This article reviews the evidence for efficacy and safety of Saccharomyces boulardii(S.boulardii) for various disease indications in adults based on the peerreviewed,randomized clinical trials and pre-clinical studies from the published medical literature(Medline,Clinical Trial websites and meeting abstracts) between 1976 and 2009.For meta-analysis,only randomized,blinded controlled trials unrestricted by language were included.Pre-clinical studies,volunteer studies and uncontrolled studies were excluded from the review of efficacy and meta-analysis,but included in the systematic review.Of 31 randomized,placebo-controlled treatment arms in 27 trials(encompassing 5029 study patients),S.boulardii was found to be significantly efficacious and safe in 84% of those treatment arms.A meta-analysis found a significant therapeutic efficacy for S.boulardii in the prevention of antibiotic-associated diarrhea(AAD)(RR = 0.47,95% CI:0.35-0.63,P < 0.001).In adults,S.boulardii can be strongly recommended for the prevention of AAD and the traveler's diarrhea.Randomized trials also support the use of this yeast probiotic for prevention of enteral nutrition-related diarrhea and reduction of Heliobacter pylori treatment-related symptoms.S.boulardii shows promise for the prevention of C.difficile disease recurrences;treatment of irritable bowel syndrome,acute adult diarrhea,Crohn's disease,giardiasis,human immunodeficiency virus-related diarrhea;but more supporting evidence is recommended for these indications.The use of S.boulardii as a therapeutic probiotic is evidence-based for both efficacy and safety for several types of diarrhea.展开更多
BACKGROUND Polymyxin-induced nephrotoxicity is a major safety concern in clinical practice due to long-term adverse outcomes and high mortality.AIM To conducted a systematic review and meta-analysis of the prevalence ...BACKGROUND Polymyxin-induced nephrotoxicity is a major safety concern in clinical practice due to long-term adverse outcomes and high mortality.AIM To conducted a systematic review and meta-analysis of the prevalence and potential predictors of polymyxin-induced nephrotoxicity in adult intensive care unit(ICU)patients.METHODS PubMed,EMBASE,the Cochrane Library and Reference Citation Analysis database were searched for relevant studies from inception through May 30,2022.The pooled prevalence of polymyxin-induced nephrotoxicity and pooled risk ratios of associated factors were analysed using a random-effects or fixed-effects model by Stata SE ver.12.1.Additionally,subgroup analyses and meta-regression were conducted to assess heterogeneity.RESULTS A total of 89 studies involving 12234 critically ill adult patients were included in the meta-analysis.The overall pooled incidence of polymyxin-induced nephrotoxicity was 34.8%.The pooled prevalence of colistin-induced nephrotoxicity was not higher than that of polymyxin B(PMB)-induced nephrotoxicity.The subgroup analyses showed that nephrotoxicity was significantly associated with dosing interval,nephrotoxicity criteria,age,publication year,study quality and sample size,which were confirmed in the univariable meta-regression analysis.Nephrotoxicity was significantly increased when the total daily dose was divided into 2 doses but not 3 or 4 doses.Furthermore,older age,the presence of sepsis or septic shock,hypoalbuminemia,and concomitant vancomycin or vasopressor use were independent risk factors for polymyxin-induced nephrotoxicity,while an elevated baseline glomerular filtration rate was a protective factor against colistin-induced nephrotoxicity.CONCLUSION Our findings indicated that the incidence of polymyxin-induced nephrotoxicity among ICU patients was high.It emphasizes the importance of additional efforts to manage ICU patients receiving polymyxins to decrease the risk of adverse outcomes.展开更多
Objective Extracorporeal membrane oxygenation is a cardiopulmonary supportive therapy. Since 2004,our institution has adopted venoarterial ECMO for adult patients who otherwise could not be weaned from cardiopulmonary...Objective Extracorporeal membrane oxygenation is a cardiopulmonary supportive therapy. Since 2004,our institution has adopted venoarterial ECMO for adult patients who otherwise could not be weaned from cardiopulmonary bypass and patients experiencing postcardiotomy cardiogenic shock and / or pulmonary dysfunction展开更多
Background:Clinical outcome of adrenocortical carcinoma(ACC)varies because of its heterogeneous nature and reliable prognostic prediction model for adult ACC patients is limited.The objective of this study was to deve...Background:Clinical outcome of adrenocortical carcinoma(ACC)varies because of its heterogeneous nature and reliable prognostic prediction model for adult ACC patients is limited.The objective of this study was to develop and externally validate a nomogram for overall survival(OS)prediction in adult patients with ACC after surgery.Methods:Based on the data from the Surveillance Epidemiology,and End Results(SEER)database,adults patients diagnosed with ACC between January 1988 and December 2015 were identified and classified into a training set,comprised of 404 patients diagnosed between January 2007 and December 2015,and an internal validation set,com-prised of 318 patients diagnosed between January 1988 and December 2006.The endpoint of this study was OS.The nomogram was developed using a multivariate Cox proportional hazards regression algorithm in the training set and its performance was evaluated in terms of its discriminative ability,calibration,and clinical usefulness.The nomogram was then validated using the internal SEER validation,also externally validated using the Cancer Genome Atlas set(TCGA,82 patients diagnosed between 1998 and 2012)and a Chinese multicenter cohort dataset(82 patients diag-nosed between December 2002 and May 2018),respectively.Results:Age at diagnosis,T stage,N stage,and M stage were identified as independent predictors for OS.A nomo-gram incorporating these four predictors was constructed using the training set and demonstrated good calibration and discrimination(C-index 95%confidence interval[CI],0.715[0.679-0.751]),which was validated in the internal validation set(C-index[95%CI],0.672[0.637-0.707]),the TCGA set(C-index[95%CI],0.810[0.732-0.888])and the Chi-nese multicenter set(C-index[95%CI],0.726[0.633-0.819]),respectively.Encouragingly,the nomogram was able to successfully distinguished patients with a high-risk of mortality in all enrolled patients and in the subgroup analyses.Decision curve analysis indicated that the nomogram was clinically useful and applicable.Conclusions:The study presents a nomogram that incorporates clinicopathological predictors,which can accurately predict the OS of adult ACC patients after surgery.This model and the corresponding risk classification system have the potential to guide therapy decisions after surgery.展开更多
Our study aimed to determine the effect of the neutrophil-lymphocyte ratio on the prognosis of adult patients with acute stroke.We searched the Web of Science,PubMed,Embase,Cochrane Library,and China National Knowledg...Our study aimed to determine the effect of the neutrophil-lymphocyte ratio on the prognosis of adult patients with acute stroke.We searched the Web of Science,PubMed,Embase,Cochrane Library,and China National Knowledge Infrastructure databases and selected all of the potentially eligible studies.From the included studies,we extracted characteristics such as the stroke type and acquisition time until routine blood collection and the odds ratios across studies.The 95%confidence intervals and odds ratios were pooled to calculate the effect size for the neutrophil-lymphocyte ratio in acute stroke patients.We defined poor function outcomes according to the modified Rankin Scale≥3 or Glasgow Outcome Scale<3.Thirteen studies with 4443 patients were included in our analysis,including 7 ischemic and 6 hemorrhagic stroke studies.The pooled odds ratios for poor functional outcome at 3 months with a higher neutrophil-lymphocyte ratio in acute ischemic and hemorrhagic patients were 1.689(95%CI=1.184-2.409,p<0.001)and 1.125(95%CI=1.022-1.239,p<0.001),respectively,and the overall pooled odds ratio for poor functional outcome following stroke was 1.257(95%CI=1.146-1.379,p<0.001).At the same time,the overall combined odds ratio for death at 3 months was 1.632(95%CI=1.155-2.306,p<0.001).The neutrophil-lymphocyte ratio,an easily calculated marker,plays a predictive role in the short-term outcomes of adult patients(mean age≥50 years)following acute ischemic and hemorrhagic stroke.展开更多
Background:Allopatry medical treatment is common in China.However,allopatry medical therapy can result in many problems,including a negative psychological impact on patients.Patients undergoing liver surgery often exp...Background:Allopatry medical treatment is common in China.However,allopatry medical therapy can result in many problems,including a negative psychological impact on patients.Patients undergoing liver surgery often experience anxiety and depression.To understand the psychological status of older adult patients undergoing surgery better,this study was designed to investigate the incidence of anxiety and depression in older adult patients undergoing elective liver surgery and to analyze factors associated with it in allopatry medical therapy.Methods:A total of 173 older adult patients undergoing elective liver surgery were included in the study.Patients were evaluated using the hospital anxiety and depression scale(HADS).The contributing factors affecting the psychological state of older adult patients undergoing elective surgery were analyzed using a linear regression method.Results:The HADS-A(hospital anxiety and depression scale-anxiety).The correlation(scale)score of the older adult patients undergoing elective liver surgery was(8.692.38),including 53 asymptomatic patients,86 suspicious patients,and 34 symptomatic patients.The HADS-D(hospital anxiety and depression scale-depression)score was(8.312.90),including 83 asymptomatic patients,56 suspicious patients,and 34 symptomatic patients.Multivariate analysis showed that residence and complication grade(Clavien–Dindo Classification of Surgical Complications or Accordion Severity Grading System)significantly correlated with the anxiety level of patients undergoing elective surgery.Residence,a requirement of blood transfusion,total transfusion volume,and Accordion complication grade showed a significant correlation with depression in patients undergoing elective surgery.Conclusions:Anxiety and depression in older adult patients undergoing elective liver surgery were common.Regional differences(local patients vs non local patients)and the severity of complications were the risk factors for anxiety and depression in older adult patients undergoing elective liver surgery.Reducing both regional differences and the severity of complications would be beneficial to alleviate the risk of anxiety and depression in older adult patients undergoing elective liver surgery and thus promote their physical and mental health.展开更多
Objective:To investigate the relation between sleep quality and glycemic control among type 2 diabetic patients.Methods:Across sectional descriptive design was used;the study sample including 125 diabetic patients was...Objective:To investigate the relation between sleep quality and glycemic control among type 2 diabetic patients.Methods:Across sectional descriptive design was used;the study sample including 125 diabetic patients was recruited at diabetic clinics in Zagazig University hospitals.The interview questionnaire sheet consists of 4 par ts:(1)demographic data,(2)medical history,(3)an Arabic version of the Pittsburgh sleep quality index(PSQI),and(4)glycated hemoglobin A1c(Hb A1c)analysis test.Results:The mean of sleep duration was the highest score of PSQI components,96.8%of diabetic patients had poor sleep quality,and 90.4%of diabetic patients had poor glycemic control.A highly statistically significant relationship was found between Hb A1c and sleep quality.Moreover,income,duration of disease and smoking were independent positive predictors of Hb A1c level,while the female gender was a statistically significant negative predictor.Additionally,female gender and income were statistically significant independent positive predictors of PSQI score.Conclusions:Poor sleep quality and poor glycemic control were very common among type 2 diabetic patients.There was a highly significant relation between sleep quality and glycemic control.展开更多
Microsatellite instability (MSI) is used as a molecular marker for defective DNA mismatch repair (MMR) genes.We report here alterations of MSI in 15 malignant astrocytomas (WHO grade Ⅲ) and glioblastomas (GBM; WHO gr...Microsatellite instability (MSI) is used as a molecular marker for defective DNA mismatch repair (MMR) genes.We report here alterations of MSI in 15 malignant astrocytomas (WHO grade Ⅲ) and glioblastomas (GBM; WHO grade Ⅳ) of pediatric patients (2-21 years) and 12 GBM from adults (44-68 years) by comparative analysis of BAT25/BAT26 loci and 10 other microsatellite markers. High-level microsatellite instability (MSI-H) occurred in 4 of the 15 pediatric cases (26.7%) and in 1 of the 12 adult GBM cases (8.3%). Low-level mi-展开更多
<b><span>Background:</span></b><span> The patients’ age is considered a modified risk factor that causes periodontal disease, dental caries, and their development.</span><b...<b><span>Background:</span></b><span> The patients’ age is considered a modified risk factor that causes periodontal disease, dental caries, and their development.</span><b><span> Objective:</span></b><span> The present study was designed to evaluate the impact of salivary pH value and dental caries index on periodontal status among adult age groups of patients from Aseer region, Saudi Arabia</span><span>.</span><span> </span><b><span>Methods:</span></b><span> A cross-sectional analysi</span><span>s carried out in the college of dentistry, King Khalid University on 750 </span><span>adult patients (400 males and 350 females). The adults patients were divided into three equal groups according to the patients’ age: group I (20 - 30 years), group I</span><span>I (31 - 40 years), and group III (41 - 50 years).</span><span> </span><span>Plaque index (PLI), gingi</span><span>val index (GI), clinical attachment loss (CAL), and the dental caries index (DMFT)</span><span> recorded as w</span><span>ell as salivary pH. All findings collected, then analyzed by an</span><span> ANOVA test and the t</span><span>-test. A p-value at <0.05 was considered a statistical significance level.</span><span> </span><b><span>R</span></b><b><span>esults:</span></b><b><span> </span></b><span>The clinical findings of the current study showed that there were statistically significant differences in the patients’ age of both males and females. Moreover, there were statistically significant diffe</span><span>rences in GI. On the other hand, there were highly statistically significant differences in PLI and DMFS, but there were no significant differences</span><span> in CAL of both males and females </span><span>Moreover, there were no statistically significant differences in salivary pH</span><span>.</span><span> </span><b><span>Conclusion:</span></b><span> We concluded that DMFT Index correlated to periodontal and oral hea</span><span>lth status and, it increased with the progression of the pat</span><span>ient’s age and</span><span> can be used in the epidemiological evaluation of periodontal and o</span><span>ral health status.展开更多
Long term care facilities have a rising rate of falls and fall related injuries with increasing cost and more hospitalization.Hourly rounding®is an evidenced based intervention that is proactive for nursing staff...Long term care facilities have a rising rate of falls and fall related injuries with increasing cost and more hospitalization.Hourly rounding®is an evidenced based intervention that is proactive for nursing staff to be able to identify patient’s needs.This helps with positive fall prevention outcome.This project focused on process improvement efforts for 10 weeks and examining the education and implementation of an evidenced-based hourly rounding program that assisted in reducing the number of falls in the pilot unit.The implementation of the intervention took place in a long-term care facility located in Dallas,Georgia.The hourly rounding tools used in this project were the Studer Group hourly rounding log and competency checklist with permission.Twenty staff members were included in the sample,age 18 years and 60 years.The unit has 41 residents who were included in the pilot case study design.Staff members were first educated regarding hourly rounding and documentation on the hourly rounding log was done two days before implementation and the pre and post fall rate was retrieved from the facilities fall database.Competency checklist was completed prior to implementation and post implementation to evaluate staff understanding of the main tenets of the 4 P’s(potty,pain,possession,and position).For this project,descriptive statistics was used to help determine fall rates.Minitab was used to analyzed data and to determine if it was clinically significant.In the ten weeks following the hourly rounding implementation,participants performed hourly rounding by incorporating it to each resident’s daily routine and documented their rounds on the log sheet.The results indicated that it is statistically significant and with a P-values=-<0.0001 and t-value=-5.81.展开更多
文摘This article reviews the evidence for efficacy and safety of Saccharomyces boulardii(S.boulardii) for various disease indications in adults based on the peerreviewed,randomized clinical trials and pre-clinical studies from the published medical literature(Medline,Clinical Trial websites and meeting abstracts) between 1976 and 2009.For meta-analysis,only randomized,blinded controlled trials unrestricted by language were included.Pre-clinical studies,volunteer studies and uncontrolled studies were excluded from the review of efficacy and meta-analysis,but included in the systematic review.Of 31 randomized,placebo-controlled treatment arms in 27 trials(encompassing 5029 study patients),S.boulardii was found to be significantly efficacious and safe in 84% of those treatment arms.A meta-analysis found a significant therapeutic efficacy for S.boulardii in the prevention of antibiotic-associated diarrhea(AAD)(RR = 0.47,95% CI:0.35-0.63,P < 0.001).In adults,S.boulardii can be strongly recommended for the prevention of AAD and the traveler's diarrhea.Randomized trials also support the use of this yeast probiotic for prevention of enteral nutrition-related diarrhea and reduction of Heliobacter pylori treatment-related symptoms.S.boulardii shows promise for the prevention of C.difficile disease recurrences;treatment of irritable bowel syndrome,acute adult diarrhea,Crohn's disease,giardiasis,human immunodeficiency virus-related diarrhea;but more supporting evidence is recommended for these indications.The use of S.boulardii as a therapeutic probiotic is evidence-based for both efficacy and safety for several types of diarrhea.
基金Supported by The Hunan Province Natural Science Foundation,No.2022JJ80043Nature Science Foundation of Changsha,No.kq2014268+1 种基金Hunan Engineering Research Center of Intelligent Prevention and Control for Drug Induced Organ Injury,No.40Scientific Research Fund Project of Hunan Pharmaceutical Society,No.2020YXH010.
文摘BACKGROUND Polymyxin-induced nephrotoxicity is a major safety concern in clinical practice due to long-term adverse outcomes and high mortality.AIM To conducted a systematic review and meta-analysis of the prevalence and potential predictors of polymyxin-induced nephrotoxicity in adult intensive care unit(ICU)patients.METHODS PubMed,EMBASE,the Cochrane Library and Reference Citation Analysis database were searched for relevant studies from inception through May 30,2022.The pooled prevalence of polymyxin-induced nephrotoxicity and pooled risk ratios of associated factors were analysed using a random-effects or fixed-effects model by Stata SE ver.12.1.Additionally,subgroup analyses and meta-regression were conducted to assess heterogeneity.RESULTS A total of 89 studies involving 12234 critically ill adult patients were included in the meta-analysis.The overall pooled incidence of polymyxin-induced nephrotoxicity was 34.8%.The pooled prevalence of colistin-induced nephrotoxicity was not higher than that of polymyxin B(PMB)-induced nephrotoxicity.The subgroup analyses showed that nephrotoxicity was significantly associated with dosing interval,nephrotoxicity criteria,age,publication year,study quality and sample size,which were confirmed in the univariable meta-regression analysis.Nephrotoxicity was significantly increased when the total daily dose was divided into 2 doses but not 3 or 4 doses.Furthermore,older age,the presence of sepsis or septic shock,hypoalbuminemia,and concomitant vancomycin or vasopressor use were independent risk factors for polymyxin-induced nephrotoxicity,while an elevated baseline glomerular filtration rate was a protective factor against colistin-induced nephrotoxicity.CONCLUSION Our findings indicated that the incidence of polymyxin-induced nephrotoxicity among ICU patients was high.It emphasizes the importance of additional efforts to manage ICU patients receiving polymyxins to decrease the risk of adverse outcomes.
文摘Objective Extracorporeal membrane oxygenation is a cardiopulmonary supportive therapy. Since 2004,our institution has adopted venoarterial ECMO for adult patients who otherwise could not be weaned from cardiopulmonary bypass and patients experiencing postcardiotomy cardiogenic shock and / or pulmonary dysfunction
基金This work was supported by the Natural Science Foundation of China(81572514,U1301221,81402106,81272808,81825016)the Natural Science Foundation of Guangdong,China(2016A030313244)Grant[2013]163 from Key Laboratory of Malignant Tumor Molecular Mechanism and Translational Medicine of Guangzhou Bureau of Science and Information Technology,Grant KLB09001 from the Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institutes,and grants from the Guangdong Science and Technology Department(2015B050501004,2017B020227007).
文摘Background:Clinical outcome of adrenocortical carcinoma(ACC)varies because of its heterogeneous nature and reliable prognostic prediction model for adult ACC patients is limited.The objective of this study was to develop and externally validate a nomogram for overall survival(OS)prediction in adult patients with ACC after surgery.Methods:Based on the data from the Surveillance Epidemiology,and End Results(SEER)database,adults patients diagnosed with ACC between January 1988 and December 2015 were identified and classified into a training set,comprised of 404 patients diagnosed between January 2007 and December 2015,and an internal validation set,com-prised of 318 patients diagnosed between January 1988 and December 2006.The endpoint of this study was OS.The nomogram was developed using a multivariate Cox proportional hazards regression algorithm in the training set and its performance was evaluated in terms of its discriminative ability,calibration,and clinical usefulness.The nomogram was then validated using the internal SEER validation,also externally validated using the Cancer Genome Atlas set(TCGA,82 patients diagnosed between 1998 and 2012)and a Chinese multicenter cohort dataset(82 patients diag-nosed between December 2002 and May 2018),respectively.Results:Age at diagnosis,T stage,N stage,and M stage were identified as independent predictors for OS.A nomo-gram incorporating these four predictors was constructed using the training set and demonstrated good calibration and discrimination(C-index 95%confidence interval[CI],0.715[0.679-0.751]),which was validated in the internal validation set(C-index[95%CI],0.672[0.637-0.707]),the TCGA set(C-index[95%CI],0.810[0.732-0.888])and the Chi-nese multicenter set(C-index[95%CI],0.726[0.633-0.819]),respectively.Encouragingly,the nomogram was able to successfully distinguished patients with a high-risk of mortality in all enrolled patients and in the subgroup analyses.Decision curve analysis indicated that the nomogram was clinically useful and applicable.Conclusions:The study presents a nomogram that incorporates clinicopathological predictors,which can accurately predict the OS of adult ACC patients after surgery.This model and the corresponding risk classification system have the potential to guide therapy decisions after surgery.
基金The work was supported by the 12th Five-year National Science and Technology Support Plan of China(2013BAH06F04 to SG)the Natural Science Foundation of The First Affiliated Hospital of Harbin Medical University(2019B01 to XX).
文摘Our study aimed to determine the effect of the neutrophil-lymphocyte ratio on the prognosis of adult patients with acute stroke.We searched the Web of Science,PubMed,Embase,Cochrane Library,and China National Knowledge Infrastructure databases and selected all of the potentially eligible studies.From the included studies,we extracted characteristics such as the stroke type and acquisition time until routine blood collection and the odds ratios across studies.The 95%confidence intervals and odds ratios were pooled to calculate the effect size for the neutrophil-lymphocyte ratio in acute stroke patients.We defined poor function outcomes according to the modified Rankin Scale≥3 or Glasgow Outcome Scale<3.Thirteen studies with 4443 patients were included in our analysis,including 7 ischemic and 6 hemorrhagic stroke studies.The pooled odds ratios for poor functional outcome at 3 months with a higher neutrophil-lymphocyte ratio in acute ischemic and hemorrhagic patients were 1.689(95%CI=1.184-2.409,p<0.001)and 1.125(95%CI=1.022-1.239,p<0.001),respectively,and the overall pooled odds ratio for poor functional outcome following stroke was 1.257(95%CI=1.146-1.379,p<0.001).At the same time,the overall combined odds ratio for death at 3 months was 1.632(95%CI=1.155-2.306,p<0.001).The neutrophil-lymphocyte ratio,an easily calculated marker,plays a predictive role in the short-term outcomes of adult patients(mean age≥50 years)following acute ischemic and hemorrhagic stroke.
基金supported by the General Project of Natural Science Foundation of Hubei Province(2020CFB826).
文摘Background:Allopatry medical treatment is common in China.However,allopatry medical therapy can result in many problems,including a negative psychological impact on patients.Patients undergoing liver surgery often experience anxiety and depression.To understand the psychological status of older adult patients undergoing surgery better,this study was designed to investigate the incidence of anxiety and depression in older adult patients undergoing elective liver surgery and to analyze factors associated with it in allopatry medical therapy.Methods:A total of 173 older adult patients undergoing elective liver surgery were included in the study.Patients were evaluated using the hospital anxiety and depression scale(HADS).The contributing factors affecting the psychological state of older adult patients undergoing elective surgery were analyzed using a linear regression method.Results:The HADS-A(hospital anxiety and depression scale-anxiety).The correlation(scale)score of the older adult patients undergoing elective liver surgery was(8.692.38),including 53 asymptomatic patients,86 suspicious patients,and 34 symptomatic patients.The HADS-D(hospital anxiety and depression scale-depression)score was(8.312.90),including 83 asymptomatic patients,56 suspicious patients,and 34 symptomatic patients.Multivariate analysis showed that residence and complication grade(Clavien–Dindo Classification of Surgical Complications or Accordion Severity Grading System)significantly correlated with the anxiety level of patients undergoing elective surgery.Residence,a requirement of blood transfusion,total transfusion volume,and Accordion complication grade showed a significant correlation with depression in patients undergoing elective surgery.Conclusions:Anxiety and depression in older adult patients undergoing elective liver surgery were common.Regional differences(local patients vs non local patients)and the severity of complications were the risk factors for anxiety and depression in older adult patients undergoing elective liver surgery.Reducing both regional differences and the severity of complications would be beneficial to alleviate the risk of anxiety and depression in older adult patients undergoing elective liver surgery and thus promote their physical and mental health.
文摘Objective:To investigate the relation between sleep quality and glycemic control among type 2 diabetic patients.Methods:Across sectional descriptive design was used;the study sample including 125 diabetic patients was recruited at diabetic clinics in Zagazig University hospitals.The interview questionnaire sheet consists of 4 par ts:(1)demographic data,(2)medical history,(3)an Arabic version of the Pittsburgh sleep quality index(PSQI),and(4)glycated hemoglobin A1c(Hb A1c)analysis test.Results:The mean of sleep duration was the highest score of PSQI components,96.8%of diabetic patients had poor sleep quality,and 90.4%of diabetic patients had poor glycemic control.A highly statistically significant relationship was found between Hb A1c and sleep quality.Moreover,income,duration of disease and smoking were independent positive predictors of Hb A1c level,while the female gender was a statistically significant negative predictor.Additionally,female gender and income were statistically significant independent positive predictors of PSQI score.Conclusions:Poor sleep quality and poor glycemic control were very common among type 2 diabetic patients.There was a highly significant relation between sleep quality and glycemic control.
文摘Microsatellite instability (MSI) is used as a molecular marker for defective DNA mismatch repair (MMR) genes.We report here alterations of MSI in 15 malignant astrocytomas (WHO grade Ⅲ) and glioblastomas (GBM; WHO grade Ⅳ) of pediatric patients (2-21 years) and 12 GBM from adults (44-68 years) by comparative analysis of BAT25/BAT26 loci and 10 other microsatellite markers. High-level microsatellite instability (MSI-H) occurred in 4 of the 15 pediatric cases (26.7%) and in 1 of the 12 adult GBM cases (8.3%). Low-level mi-
文摘<b><span>Background:</span></b><span> The patients’ age is considered a modified risk factor that causes periodontal disease, dental caries, and their development.</span><b><span> Objective:</span></b><span> The present study was designed to evaluate the impact of salivary pH value and dental caries index on periodontal status among adult age groups of patients from Aseer region, Saudi Arabia</span><span>.</span><span> </span><b><span>Methods:</span></b><span> A cross-sectional analysi</span><span>s carried out in the college of dentistry, King Khalid University on 750 </span><span>adult patients (400 males and 350 females). The adults patients were divided into three equal groups according to the patients’ age: group I (20 - 30 years), group I</span><span>I (31 - 40 years), and group III (41 - 50 years).</span><span> </span><span>Plaque index (PLI), gingi</span><span>val index (GI), clinical attachment loss (CAL), and the dental caries index (DMFT)</span><span> recorded as w</span><span>ell as salivary pH. All findings collected, then analyzed by an</span><span> ANOVA test and the t</span><span>-test. A p-value at <0.05 was considered a statistical significance level.</span><span> </span><b><span>R</span></b><b><span>esults:</span></b><b><span> </span></b><span>The clinical findings of the current study showed that there were statistically significant differences in the patients’ age of both males and females. Moreover, there were statistically significant diffe</span><span>rences in GI. On the other hand, there were highly statistically significant differences in PLI and DMFS, but there were no significant differences</span><span> in CAL of both males and females </span><span>Moreover, there were no statistically significant differences in salivary pH</span><span>.</span><span> </span><b><span>Conclusion:</span></b><span> We concluded that DMFT Index correlated to periodontal and oral hea</span><span>lth status and, it increased with the progression of the pat</span><span>ient’s age and</span><span> can be used in the epidemiological evaluation of periodontal and o</span><span>ral health status.
文摘Long term care facilities have a rising rate of falls and fall related injuries with increasing cost and more hospitalization.Hourly rounding®is an evidenced based intervention that is proactive for nursing staff to be able to identify patient’s needs.This helps with positive fall prevention outcome.This project focused on process improvement efforts for 10 weeks and examining the education and implementation of an evidenced-based hourly rounding program that assisted in reducing the number of falls in the pilot unit.The implementation of the intervention took place in a long-term care facility located in Dallas,Georgia.The hourly rounding tools used in this project were the Studer Group hourly rounding log and competency checklist with permission.Twenty staff members were included in the sample,age 18 years and 60 years.The unit has 41 residents who were included in the pilot case study design.Staff members were first educated regarding hourly rounding and documentation on the hourly rounding log was done two days before implementation and the pre and post fall rate was retrieved from the facilities fall database.Competency checklist was completed prior to implementation and post implementation to evaluate staff understanding of the main tenets of the 4 P’s(potty,pain,possession,and position).For this project,descriptive statistics was used to help determine fall rates.Minitab was used to analyzed data and to determine if it was clinically significant.In the ten weeks following the hourly rounding implementation,participants performed hourly rounding by incorporating it to each resident’s daily routine and documented their rounds on the log sheet.The results indicated that it is statistically significant and with a P-values=-<0.0001 and t-value=-5.81.
