Importance/Objective: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent injury. We suggest that available medical information and digit...Importance/Objective: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent injury. We suggest that available medical information and digital/electronic methods could be used to manage this major healthcare problem for individual patients in real time. Methods: We searched the available digital applications and three literature databases using the medical subject heading terms, adverse drug reaction reporting systems or management, filtered by clinical trial or systemic reviews, to detect publications with data about ADR identification and management approaches. We reviewed the reports that had abstract or summary data or proposed or implemented methods or systems with potential to identify or manage ADRs in clinical settings. Results: The vast majority of the 481 reports used retrospectively collected data for groups of patients or were limited to surveying one population group or class of medication. The reports showed potential and definite associations of ADRs for specific drugs and problems, mostly, but not exclusively, for patients in hospitals and nursing homes. No reports described complete methods to collect comprehensive data on ADRs for individual patients in a healthcare system. The digital applications have ADR information, but all are too cumbersome or incomplete for use in active clinical settings. Several studies suggested that providing information about potential ADRs to clinicians can reduce these problems. Conclusion and Relevance: Although investigators and government agencies agree with the need, there is no comprehensive ADR management program in current use. Informing the patient’s healthcare practitioners of potential ADRs at the point of service has the potential for reduction of these complications, which should improve healthcare and reduce unneeded costs.展开更多
Background In-hospital medical complications are associated with poorer clinical outcomes for stroke patients after disease onset. However, few studies from China have reported the effect of these complications on the...Background In-hospital medical complications are associated with poorer clinical outcomes for stroke patients after disease onset. However, few studies from China have reported the effect of these complications on the mortality of patients with acute ischemic stroke. In this prospective work, the China National Stroke Registry Study, we investigated the effect of medical complications on the case fatality of patients with acute ischemic stroke. Methods From September 2007 to August 2008, we prospectively obtained the data of patients with acute stroke from 132 clinical centers in China. Medical complications, case fatality and other information recorded at baseline, during hospitalisation, and at 3, 6, and 12 months after stroke onset. Multivariable Logistic regression was performed to analyze the effect of medical complications on the case fatality of patients with acute ischemic stroke. Results There were 39741 patients screened, 14526 patients with acute ischemic stroke recruited, and 11 560 ischemic stroke patients without missing data identified during the 12-month follow-up. Of the 11 560 ischemic patients, 15.8% （1826） had in-hospital medical complications. The most common complication was pneumonia （1373; 11.9% of patients）, followed by urinary tract infection and gastrointestinal bleeding. In comparison with patients without complications, stroke patients with complications had a significantly higher risk of death during their hospitalization, and at 3, 6 and 12 months post-stroke. Having any one in-hospital medical complication was an independent risk factor for death in patients with acute ischemic stroke during hospital period （adjusted OR=6.946; 95% CI 5.181 to 9.314）, at 3 months （adjusted OR=3.843; 95% C/3.221 to 4.584）, 6 months （adjusted OR=3.492; 95% CI 2.970 to 4.106）, and 12 months （adjusted OR= 3.511; 95% CI 3.021 to 4.080）. Having multiple complications strongly increased the death risk of patients. Conclusion Short-term and long-term outcomes of acute stroke patients are affected by in-hospital medical complications.展开更多
Background The mortality of stroke patients is strongly affected by medical complications. However, there are limited data investigating the effect of in-hospital medical complications on the dependency of stroke pati...Background The mortality of stroke patients is strongly affected by medical complications. However, there are limited data investigating the effect of in-hospital medical complications on the dependency of stroke patients worldwide. We prospectively and systematically investigated the effect of medical complications on dependency of patients at 3, 6 and 12 months after stroke using the China National Stroke Registry （CNSR）. Methods This prospective cohort study collected data of patients age 〉18 years with acute ischemic stroke in 132 clinical centers distributed across 32 provinces and four municipalities （including Hong Kong region） of China, from September 2007 to August 2008. Data on medical complications, dependency and other information were obtained from paper-based registry forms. Medical complications associated with stroke outcomes were assessed using multivariable Logistic regression. Results Of 11 560 patients with acute ischemic stroke, 1826 （15.80%） presented with in-hospital medical complications. In-hospital medical complications were independent risk factors for dependency of patients at 3 months （adjusted odds ratio （OR） 2.367, 95% confidence interval （CI） 2.021-2.771）, 6 months （adjusted OR 2.257, 95% CI 1.922-2.650）, and 12 months （adjusted OR 1.820, 95% CI 1.538-2.154） after acute ischemic stroke. Conclusion The results demonstrated that the short-term and long-term dependency of acute ischemic stroke patients is significantly associated with in-hospital medical complications in China.展开更多
Objective: To evaluate the therapeutic efficacy of acupuncture plus Chinese medicinal fumigation and washing in treating edema of the affected limb in post-stroke hemiplegia. Methods: Two hundred patients with edema o...Objective: To evaluate the therapeutic efficacy of acupuncture plus Chinese medicinal fumigation and washing in treating edema of the affected limb in post-stroke hemiplegia. Methods: Two hundred patients with edema of the stroke-affected limb from our hospital were randomized into two groups according to their visiting sequence. In the observation group, 100 subjects were intervened by acupuncture plus Chinese medicinal fumigation and washing in addition to oral administration of diuretics, while the other 100 subjects in the control group were only given diuretics. The therapeutic efficacy was evaluated after successive 2-week treatments. Results: The total effective rate was 90.0% in the observation group, significantly higher than 66.0% in the control group, indicating that there was a significant difference in comparing the overall therapeutic effect(P<0.01). Conclusion: Acupuncture plus Chinese medicinal fumigation and washing in addition to oral administration of diuretics is effective in treating edema of the affected limb in post-stroke hemiplegia.展开更多
Objective: To observe the clinical efficacy of acupuncture plus patent Chinese medicine in treating post-stroke constipation. Methods: Sixty eligible patients with post-stroke constipation were randomized into a treat...Objective: To observe the clinical efficacy of acupuncture plus patent Chinese medicine in treating post-stroke constipation. Methods: Sixty eligible patients with post-stroke constipation were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by acupuncture plus Ma Zi Ren pill, while the control group was by Ma Zi Ren pill alone. The symptoms of constipation were observed before and after intervention. Results: After 2-week treatment, the constipation condition was improved in both groups, and the improvement in the treatment group was statistically more significant than that in the control group(P<0.05); respectively two weeks and a month after the intervention, the treatment group was superior to the control group in comparing the constipation score(P<0.05). However, acupuncture didn't show marked effect in improving defecation speed, initial defecation time, and spontaneous discharge frequency. The treatment group had a significantly higher short-term markedly-effective rate compared with the control group(P<0.05); the long-term therapeutic efficacy of the treatment group was significantly higher than that of the control group(P<0.05). The adverse events happened in the treatment group were significantly less than those in the control group(P<0.05). Conclusion: Acupuncture at specific acupoints plus patent Chinese medicine can produce a content therapeutic efficacy.展开更多
文摘Importance/Objective: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent injury. We suggest that available medical information and digital/electronic methods could be used to manage this major healthcare problem for individual patients in real time. Methods: We searched the available digital applications and three literature databases using the medical subject heading terms, adverse drug reaction reporting systems or management, filtered by clinical trial or systemic reviews, to detect publications with data about ADR identification and management approaches. We reviewed the reports that had abstract or summary data or proposed or implemented methods or systems with potential to identify or manage ADRs in clinical settings. Results: The vast majority of the 481 reports used retrospectively collected data for groups of patients or were limited to surveying one population group or class of medication. The reports showed potential and definite associations of ADRs for specific drugs and problems, mostly, but not exclusively, for patients in hospitals and nursing homes. No reports described complete methods to collect comprehensive data on ADRs for individual patients in a healthcare system. The digital applications have ADR information, but all are too cumbersome or incomplete for use in active clinical settings. Several studies suggested that providing information about potential ADRs to clinicians can reduce these problems. Conclusion and Relevance: Although investigators and government agencies agree with the need, there is no comprehensive ADR management program in current use. Informing the patient’s healthcare practitioners of potential ADRs at the point of service has the potential for reduction of these complications, which should improve healthcare and reduce unneeded costs.
文摘Background In-hospital medical complications are associated with poorer clinical outcomes for stroke patients after disease onset. However, few studies from China have reported the effect of these complications on the mortality of patients with acute ischemic stroke. In this prospective work, the China National Stroke Registry Study, we investigated the effect of medical complications on the case fatality of patients with acute ischemic stroke. Methods From September 2007 to August 2008, we prospectively obtained the data of patients with acute stroke from 132 clinical centers in China. Medical complications, case fatality and other information recorded at baseline, during hospitalisation, and at 3, 6, and 12 months after stroke onset. Multivariable Logistic regression was performed to analyze the effect of medical complications on the case fatality of patients with acute ischemic stroke. Results There were 39741 patients screened, 14526 patients with acute ischemic stroke recruited, and 11 560 ischemic stroke patients without missing data identified during the 12-month follow-up. Of the 11 560 ischemic patients, 15.8% （1826） had in-hospital medical complications. The most common complication was pneumonia （1373; 11.9% of patients）, followed by urinary tract infection and gastrointestinal bleeding. In comparison with patients without complications, stroke patients with complications had a significantly higher risk of death during their hospitalization, and at 3, 6 and 12 months post-stroke. Having any one in-hospital medical complication was an independent risk factor for death in patients with acute ischemic stroke during hospital period （adjusted OR=6.946; 95% CI 5.181 to 9.314）, at 3 months （adjusted OR=3.843; 95% C/3.221 to 4.584）, 6 months （adjusted OR=3.492; 95% CI 2.970 to 4.106）, and 12 months （adjusted OR= 3.511; 95% CI 3.021 to 4.080）. Having multiple complications strongly increased the death risk of patients. Conclusion Short-term and long-term outcomes of acute stroke patients are affected by in-hospital medical complications.
文摘Background The mortality of stroke patients is strongly affected by medical complications. However, there are limited data investigating the effect of in-hospital medical complications on the dependency of stroke patients worldwide. We prospectively and systematically investigated the effect of medical complications on dependency of patients at 3, 6 and 12 months after stroke using the China National Stroke Registry （CNSR）. Methods This prospective cohort study collected data of patients age 〉18 years with acute ischemic stroke in 132 clinical centers distributed across 32 provinces and four municipalities （including Hong Kong region） of China, from September 2007 to August 2008. Data on medical complications, dependency and other information were obtained from paper-based registry forms. Medical complications associated with stroke outcomes were assessed using multivariable Logistic regression. Results Of 11 560 patients with acute ischemic stroke, 1826 （15.80%） presented with in-hospital medical complications. In-hospital medical complications were independent risk factors for dependency of patients at 3 months （adjusted odds ratio （OR） 2.367, 95% confidence interval （CI） 2.021-2.771）, 6 months （adjusted OR 2.257, 95% CI 1.922-2.650）, and 12 months （adjusted OR 1.820, 95% CI 1.538-2.154） after acute ischemic stroke. Conclusion The results demonstrated that the short-term and long-term dependency of acute ischemic stroke patients is significantly associated with in-hospital medical complications in China.
基金supported by the Third Affiliated Hospital of Zhejiang Chinese Medical University
文摘Objective: To evaluate the therapeutic efficacy of acupuncture plus Chinese medicinal fumigation and washing in treating edema of the affected limb in post-stroke hemiplegia. Methods: Two hundred patients with edema of the stroke-affected limb from our hospital were randomized into two groups according to their visiting sequence. In the observation group, 100 subjects were intervened by acupuncture plus Chinese medicinal fumigation and washing in addition to oral administration of diuretics, while the other 100 subjects in the control group were only given diuretics. The therapeutic efficacy was evaluated after successive 2-week treatments. Results: The total effective rate was 90.0% in the observation group, significantly higher than 66.0% in the control group, indicating that there was a significant difference in comparing the overall therapeutic effect(P<0.01). Conclusion: Acupuncture plus Chinese medicinal fumigation and washing in addition to oral administration of diuretics is effective in treating edema of the affected limb in post-stroke hemiplegia.
基金supported by the Affiliated Hospital of Hebei United University
文摘Objective: To observe the clinical efficacy of acupuncture plus patent Chinese medicine in treating post-stroke constipation. Methods: Sixty eligible patients with post-stroke constipation were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by acupuncture plus Ma Zi Ren pill, while the control group was by Ma Zi Ren pill alone. The symptoms of constipation were observed before and after intervention. Results: After 2-week treatment, the constipation condition was improved in both groups, and the improvement in the treatment group was statistically more significant than that in the control group(P<0.05); respectively two weeks and a month after the intervention, the treatment group was superior to the control group in comparing the constipation score(P<0.05). However, acupuncture didn't show marked effect in improving defecation speed, initial defecation time, and spontaneous discharge frequency. The treatment group had a significantly higher short-term markedly-effective rate compared with the control group(P<0.05); the long-term therapeutic efficacy of the treatment group was significantly higher than that of the control group(P<0.05). The adverse events happened in the treatment group were significantly less than those in the control group(P<0.05). Conclusion: Acupuncture at specific acupoints plus patent Chinese medicine can produce a content therapeutic efficacy.
