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A Retrospective Analysis of Intoxicated Patients Admitted to the Intensive care Unit: A Single-Institution Assessment in the Post-Pandemic Period

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Journal of Biosciences and Medicines 2024年第3期12卷 159-167页

作者： Müge Arikan Abdullah Yeşilkaya Büşra Nur Taşdelen İbrahim Özyiğit department of Anesthesia and Intensive care Faculty of Medicine Karabuk University Karabuk Turkey

Background: The aim of this study was to evaluate the clinical and epidemiological characteristics of patients with acute intoxication admitted to the Intensive care Unit (ICU). Material and Methods: An observational retrospective study was conducted on intoxicated patients who admitted to ICU between January 2022 and January 2024. Data were collected from the patients medical records. The demographic characteristics, causes of intoxications, clinical parameters, the mean stay in the ICU, treatment modalities and prognosis were recorded. Results: A total of 2875 critically ill patients were admitted during the study period, and 109 (3.79%) of them were acute intoxications. Their mean of ages was 38.09 ± 12.29. The female-to-male ratio was 1.37/1. Drugs were found to be the primary cause (62.39%) of intoxications, and analgesics, antidepressants, and antibiotics were the most frequent agents. Suicidal attempts were present in 66 patients, most of them were female (62.13%) and between 17 - 24 years (40.91%). The other common causes of intoxications were carbon monoxide (CO) (22.02%), methyl/ethyl alcohol (8.26%) and mushroom (5.50%). The mean stay in the ICU was 2.69 ± 0.89 days. Mechanical ventilation was applied to 10 of our patients. Renal replacement therapy was required in 6 patients. Despite all treatments, 6 of our patients died, and we found the mortality rate to be 5.50%. Conclusion: Intoxications were more frequent in young female patients and drugs were the most common cause with suicidal intent. Unfortunately, CO poisoning continues to be a very important problem in our city. These findings provided significant information about the characteristics of intoxications in Karabuk.

关键词： Intoxication Intensive care Unit Suicidal Mortality

Evolution of transbronchial needle aspiration needles: Over the last half century

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Chinese Medical Journal Pulmonary and Critical care Medicine 2024年第3期2卷 162-170页

作者： Yin Zhu Hui Shen Andrew D Lerner Qin Li Si Chen Lingxiao Zhou Jiaqi Zhou Yang Xia Kopen Wang department of Respiratory and Critical care Medicine Key Laboratory of Respiratory Disease of Zhejiang ProvinceSecond Affiliated Hospital of Zhejiang University School of MedicineHangzhouZhejiang 310009China Cancer Center Zhejiang UniversityHangzhouZhejiang 310058China department of Pulmonary and Critical care Medicine Johns Hopkins University School of MedicineBaltimoreMD 21224USA department of Respiratory Endoscopy Shanghai Chest HospitalShanghai Jiao Tong UniversityShanghai 200030China

Transbronchial needle aspiration(TBNA)is a commonly used sampling approach in the diagnosis of hilar and mediastinal lymphadenopathy as well as peripheral *** a very important tool,the continued innovation of TBNA needles is a vital driving force for the development of the *** TBNA plays an important role in interventional pulmonology,there are no clear standards guiding operators to choose an appropriate needle for their *** recent decades,with the advent of endobronchial ultrasound-guided TBNA(EBUS-TBNA),the real-time visualization of TBNA has been *** modern TBNA needles,such as ViziShot2,FLEX 19G,Acquire FNB,and EchoTip ProCore,have made significant progress in specimen collection,convenience,and safety,though still remain grounded in the basic premise and initial upgrades to the original conventional TBNA(cTBNA)*** review introduced the developmental history of WANG cTBNA needles,and summarized the lessons of success and failure and the enlightenments for currently used EBUS-and other emerging TBNA needles,aiming to provide a significant reference for pulmonologists who lived through the cTBNA era and for junior physicians who start working in the EBUS-TBNA *** its long history,TBNA is still playing significant roles in the diagnosis of pulmonary diseases.A deeper understanding from the historical perspectives would facilitate continued innovations in the field of TBNA and beyond.

关键词： Bronchoscopy Endobronchial ultrasound Needle Transbronchial needle aspiration Needle sizes Bronchoscopy navigation systems Robotic bronchoscopy

Time to recovery from severe pneumonia and its predictors among pediatric patients admitted in Mizan-Tepi University Teaching Hospital,South West Ethiopia,2022

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Frontiers of Nursing 2024年第3期11卷 343-353页

作者： Belete Fenta Kebede Aynalem Yetwale Hiwot Tsegaw Biyazin Tesfa Yalemtsehay Dagnaw Genie Nigatu Dessalegn Mulu department of Midwifery College of Medicine and Health SciencesDebre Markos UniversityDebre Markos 269Ethiopia department of Midwifery Woldiya UniversityWoldiyaEthiopia School of Midwifery Institute of HealthJimma UniversityJimma 378Ethiopia department of Pediatrics and Child health Nursing Debre Markos UniversityDebre Markos 269Ethiopia department of Pediatrics and Child health Nursing Injibara UniversityInjibaraEthiopia

Objective:Despite trials and programs for the prevention of childhood mortality due to pneumonia,Ethiopia is among the top five countries with the highest number of deaths due to *** the prevalence of pneumonia has increased in the abovementioned trials,little is known about the recovery time from severe pneumonia and its predictors in the study ***,this study aimed to assess the time to recovery from severe pneumonia and its predictors among pediatric patients admitted to Mizan-Tepi University Teaching Hospital,Ethiopia,in ***:A total of 591 children admitted for severe pneumonia were selected using simple random *** were entered into Epi-data version 4.***.2.1 and expor ted to STATA version 14 for analysis,and the assumptions of Cox propor tional hazard models and goodness of fit were assessed through Shoenfeld residual and Cox-Snell residual,*** and multivariable Cox regression models were used to identify the predictors of mor ***:This study revealed that 91.54%(95%confidence interval[CI]:89.00–93.53)of participants recovered with an incidence rate of 24.10(95%CI:22.15–26.21)per 100 person-day–*** hmedian recovery time of children was 4 days(95%CI:2–6).Children who were not exclusively breastfed(AHR=1.3;95%CI:1.03–1.66),who had a history of inability to suck/feed(AHR=0.81;95%CI:0.65–0.99)were independent predictors of the time to ***:Children with severe pneumonia who had not exclusively breastfed and who had a history of inability to suck/feed were independent predictors of time to ***,all stakeholders and concerned health care providers should focus more on early diagnosis and management and hasten early recovery based on the identified factors.

关键词： Mizan-Tepi University Teaching Hospital pediatric patients predictors severe pneumonia Southwest Ethiopia time to recovery

Effects of traditional Chinese medicine on treatment outcomes in severe COVID-19 patients:a single-centre study

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Chinese Journal of Natural Medicines 2024年第1期22卷 89-96页

作者： XIAO Yongjiu LI Binbin LIU Chang HUANG Xiuyu MA Ling QIAN Zhirong ZHANG Xiaopeng ZHANG Qian LI Dunqing CAI Xiaoqing YAN Xiangyong LUO Shuping XIANG Dawei XIAO Kun Emergency department the 940th Hospital of Jiont Logistics Support Force of Chinese People’s Liberation ArmyLanzhou 730050China Scientific Research Center the Seventh Affiliated HospitalSun Yat-sen UniversityShenzhen 518000China School of Medicine Nankai universityTianjin 300000China department of Cardiology the 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation ArmyLanzhou 730050China department of Radiation Oncology Fujian Medical University Union HospitalFuzhou 350000China department of Traditional Chinese Medicine the 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation ArmyLanzhou 730050China department of Geriatric Diseases the Seventh Medical Center of Chinese PLA General HospitalBeijing 100700China health and Sport Administration Muskingum UniversityOhioanUSA Laboratory of Vaccine and Antibody Engineering Beijing Institute of BiotechnologyBeijing 100071China department of Pulmonary and Critical care Medicine the 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation ArmyLanzhou 730050China Center of Pulmonary&Critical care Medicine Chinese People’s Liberation Army(PLA)General HospitalBeijing 100853China

As the search for effective treatments for COVID-19 continues,the high mortality rate among critically ill patients in Intensive care Units(ICU)presents a profound *** study explores the potential benefits of traditional Chinese medicine(TCM)as a supplementary treatment for severe COVID-19.A total of 110 critically ill COVID-19 patients at the Intensive care Unit(ICU)of Vulcan Hill Hospital between Feb.,2020,and April,2020(Wuhan,China)participated in this observational *** patients received standard supportive care protocols,with a subset of 81 also receiving TCM as an adjunct *** characteristics during the treatment period and the clinical outcome of each patient were closely monitored and *** findings indicated that the TCM group exhibited a significantly lower mortality rate compared with the non-TCM group(16 of 81 vs 24 of 29;0.3 vs 2.3 person/month).In the adjusted Cox proportional hazards models,TCM treatment was associated with improved survival odds(Pvery of multiple organic functions,thereby potentially increasing the survival rate of critically ill COVID-19 patients.

关键词： COVID-19 Pneumonia Novel coronavirus Critically ill Traditional Chinese medicine Clinical outcome

Associated Factors of Dental Caries among Intellectually Disabled persons in Specialized Centers of Ouagadougou

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Open Journal of Epidemiology 2024年第2期14卷 297-311页

作者： Jocelyne Valerie Gare Filwende Dan Kientega Ouedraogo Carole Nathaie Tenin Ouattara Seydou Kabore Wendpoulomde Aime Désire Nicolas Meda Training and Research Unit in health Sciences Department of Public Health Joseph Ki Zerbo University Ouagadougou Burkina Faso Training and Research Unit in health Sciences Department of Dental Surgery Joseph Ki Zerbo University Ouagadougou Burkina Faso

Introduction: Several studies have reported a high prevalence of dental caries among the people with intellectual disabilities. In order to identify the sociodemographic, clinical and behavioral factors associated with it, we conducted a study in specialized centers welcoming subjects with intellectual disabilities in Ouagadougou (Burkina Faso). Objectives: The objective of this study was to identify the factors associated with it among intellectually disabled in the specialized centers of Ouagadougou. Methods: The study was cross-sectional analytical. The survey took place between November 2020 and January 2021 among people with intellectual disabilities in reception centers receiving a grant from the Ministry of Women, National Solidarity, Family and Humanitarian Action. Data collection was done with a questionnaire adapted from the World health Organization (WHO) and dental caries was recorded according to WHO criteria in decayed, missing or filled teeth generating a DMF index. Logistic regression was used to identify factors associated with the presence of dental caries. Results: A total of 193 participants were included in the study with an average age of 12.4 years ± 7.9. The overall prevalence of caries measured with the DMF index was 58.6% 95% CI [51.2 - 65.8]. It was significantly associated with female gender (OR = 4.2;95% CI [1.4 - 12.5], p = 0,01), the clinical form of mental illness (epilepsy OR = 3.8 95%;CI [1.2 - 12.7], p = 0,02, trisomy OR = 5.0;95% CI [1.1 - 22.9], p = 0,03, motor autonomy OR = 0.2 95%;CI [0.1 - 0.7], p = 0,01) and at use of toothpaste OR = 9.33;95% CI [1.05 - 82.7], p = 0,04. Conclusion: Dental caries remains a very present pathology in most people living with an intellectual disability. Also, it is necessary to put in place prevention strategies to reduce its prevalence and improve access to oral care for these people.

关键词： Dental Caries Mental Disability Intellectual Disability Associated Factors Ouagadougou

Exploring the meaning of care among lived experiences of patients with blindness:an interpretive phenomenological study

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Frontiers of Nursing 2024年第3期11卷 319-326页

作者： Mohammad Ali Mohammadi Mehdi Heidarzadeh Saeed Mehri Mahmood Shamshiri department of Medical-Surgical Nursing School of Nursing and MidwiferyArdabil University of Medical SciencesArdabil ***Iran department of Emergency Nursing School of Nursing and MidwiferyArdabil University of Medical SciencesArdabil ***Iran department of Critical care Nursing School of Nursing and MidwiferyArdabil University of Medical SciencesArdabil ***Iran

Objective:To explore the meaning of care experienced by people with blindness in ***:Interpretive phenomenology along with the 6-step method of van Manen was used to conduct the *** purposeful sampling,15 people with legal blindness were *** analysis was used to isolate the meaning of ***:Five themes emerged:(a)nurses in the eyes of patients with blindness;(b)negligence in the caring moments;(c)being cared for in ambiguity;(d)Uncoordinated care;and(e)Psychological discomfor *** sub-themes were condensed into an overarching theme titled as“marginalized patients inside the stereotypical healthcare system.”Conclusions:Lived experiences of patients with blindness revealed that hospitals provide stereotypic or inappropriate care for this minority group in *** professionals par ticularly nurses should be skilled to provide person-centered and coordinated care for patients with blindness.

关键词： hospitalization lived experience meaning of care people with blindness phenomenology

fRAP 2.0:a community engagement method applied to cervical cancer disparities among Hispanic women

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Family Medicine and Community health 2024年第S2期12卷 44-57页

作者： Autumn M Kieber-Emmons Susan E Hansen Michael Topmiller Jaskaran Grewal Carlos Roberto Jaen Benjamin F Crabtree William L Miller department of Family Medicine Lehigh Valley Health NetworkAllentownPennsylvaniaUSA College of Medicine USFTampaFloridaUSA Lehigh Valley health Network AllentownPennsylvaniaUSA American Academy of Family Physicians-health Landscape CincinattiOHUSA Lafayette College EastonPennsylvaniaUSA UT health San Antonio San AntonioTexasUSA Rutgers Robert Wood Johnson Medical School PiscatawayNew JerseyUSA Cancer Institute of New Jersey New BrunswickNew JerseyUSA

focused Rapid Assessment Process(fRAP)2.0 is a community engagement approach combining geospatial mapping with rapid qualitative assessment in cyclical fashion within communities to capture multifactorial and multilevel features impacting primary care *** 2.0 offers primary care researchers a methodology framework for exploring complex community features that impact primary healthcare delivery and *** fRAP 2.0 study design expands the fRAP from a sequential design to a cyclical process of geospatial mapping and rapid qualitative assessment in search of modifiable contextual *** participants are stakeholders from various socioecological levels whose perspectives inform study outcomes that they may use to then become the agents of change for the very problems they helped ***,we present a proof-of-concept study for fRAP 2.0 examining disparities in cervical cancer mortality rates among Hispanic women in *** primary outcomes of interest are features at the community level,medical health system level and regional government policy levels that offer opportunities for collaborative interventions to improve cervical cancer *** this study,geospatial mapping of county and ZIP code-level variables impacting postdiagnosis cervical cancer care at community,medical and policy levels were created using publicly available data and then overlaid with maps created with Texas Cancer Registry data for cervical cancer cases in three of the largest population *** disparate areas were then qualitatively explored using participant observation and ethnographic field work,alongside 39 key informant *** discussion groups and stakeholder engagement existed at every phase of the *** the fRAP 2.0 method,we created an action-oriented roadmap of next steps to improve cervical cancer care disparities in the three Texas counties with emphasis on the high disparity *** identified local change

关键词： cervical qualitative policy

Myocardial injury caused by Amanita pseudoporphyria Hongo

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World Journal of Emergency Medicine 2024年第5期15卷 401-403页

作者： Junliang Xiao Chengliang Liao Xiquan Yan Xiaotong Han Maiying Fan department of Emergency Medicine the First Affi liated Hospital of Hunan Normal University(People's Hospital of Hunan Province)Changsha 410005China Clinical Research Center For Emergency and Critical care in Hunan Province Changsha 410005China Hunan Provincial Institute of Emergency Medicine Changsha 410005China Hunan Provincial Key Laboratory of Emergency and Critical care Metabonomics Changsha 410005China

Amanita pseudoporphyria Hongo(APH)is a toxic mushroom containing Amanita toxin that is notably associated with liver and kidney function impairment.[1]Acute myocardial infarction(AMI)is a severe stage of coronary heart disease that can cause sudden death and is the leading cause of mortality and morbidity across the world.[2]The incidence rate of myocardial injury caused by accidental ingestion of APH is very *** this study,we aimed to report 11 patients who had varying degrees of myocardial injury,reduced heart function,and even cardiac arrest after accidental ingestion of APH.

关键词： mortality injury coronary

Relevance of plasma lipoproteins and small metabolites in assessment of nutritional status among patients with severe injuries

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Journal of Intensive Medicine 2024年第4期4卷 496-507页

作者： Esmee A.H.Verheul Suzan Dijkink Pieta Krijnen Aswin Verhoeven Martin Giera Roula Tsonaka Jochem M.Hoogendoorn Sesmu M.Arbous Ron Peters Inger B.Schipper department of Trauma Surgery Leiden University Medical CenterLeidenThe Netherlands Acute care Network West Netherlands LeidenThe Netherlands Center for Proteomics and Metabolomics Leiden University Medical CenterLeidenThe Netherlands department of Biomedical Data Sciences Leiden University Medical CenterLeidenThe Netherlands department of General Surgery Haaglanden Medical CenterThe HagueThe Netherlands department of Intensive care Leiden University Medical CenterLeidenThe Netherlands department of Intensive care Haaglanden Medical CenterThe HagueThe Netherlands

Background:This study aimed to identify plasma lipoproteins and small metabolites associated with high risk of malnutrition during intensive care unit(ICU)stay in patients with severe ***:This observational prospective exploratory study was conducted at two level-1 trauma centers in the *** patients(aged≥18 years)who were admitted to the ICU for more than 48 h between July 2018 and April 2022 owing to severe injuries(polytrauma,as defined by Injury Severity Scores of≥16)caused by blunt trauma were eligible for *** least squares discriminant analysis was used to analyze the relationship of 112 lipoprotein-related components and 23 small metabolites with the risk of malnutrition(mod-ified Nutrition Risk in Critically Ill score).Malnutrition was diagnosed based on Subjective Global Assessment *** relationship of lipoprotein properties and small metabolite concentrations with malnutrition(during ICU admission)was evaluated using mixed effects logistic ***:Overall,51 patients were ***(very)low-density lipoprotein([V]LDL)(free)cholesterol and phospholipid levels,low particle number,and higher levels of LDL triglycerides were associated with a higher risk of malnutrition(variable importance in projection[VIP]value>1.5).Low levels of most(V)LDL and intermediate-density lipoprotein subfractions and high levels of high-density lipoprotein Apo-A1 were associated with the diagnosis of malnutrition(VIP value>1.5).Increased levels of dimethyl sulfone,trimethylamine N-oxide,creatinine,N,N-dimethylglycine,and pyruvic acid and decreased levels of creatine,methionine,and acetoacetic acid were also indicative of malnutrition(VIP value>1.5).Overall,14 lipoproteins and 1 small metabolite were significantly associated with a high risk of malnutrition during ICU admission(Pvery rate(P=0.35 for all).Conclusion:Increased triglyceride in sev

关键词： Trauma Severely injured Metabolites Lipoproteins Malnutrition Nutritional status