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Effectiveness of post-COVID-19 primary care attendance in improving survival in very old patients with multimorbidity:a territory-wide target trial emulation

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Family Medicine and Community health 2024年第3期12卷 25-35页

作者： Cuiling Wei Vincent Ka Chun Yan Camille Maringe Wenxin Tian Rachel Yui Ki Chu Wenlong Liu Boyan Liu Yuqi Hu Lingyue Zhou Celine Sze Ling Chui Xue Li Eric Yuk Fai Wan Ching Lung Cheung Esther Wai Yin Chan William Chi Wai Wong Ian Chi Kei Wong Francisco Tsz Tsun Lai Centre for Safe Medication Practice and Research Department of Pharmacology and PharmacyLi Ka Shing Faculty of MedicineThe University of Hong KongHong KongHong Kong department of health Services Research and Policy Faculty of Public Health and PolicyLondon School of Hygiene and Tropical MedicineLondonUK School of Nursing Li Ka Shing Faculty of MedicineThe University of Hong KongHong KongHong Kong School of Public health Li Ka Shing Faculty of MedicineThe University of Hong KongHong KongHong Kong Laboratory of Data Discovery for health(D24H) Hong KongHong Kong Advanced Data Analytics for Medical Science(ADAMS)Limited Hong KongHong Kong department of Medicine School of Clinical MedicineLi Ka Shing Faculty of MedicineThe University of Hong KongHong KongHong Kong department of Family Medicine and Primary care School of Clinical MedicineLi Ka Shing Faculty of MedicineThe University of Hong KongHong KongHong Kong department of Pharmacy The University of Hong Kong-Shenzhen HospitalShenzhenPeople's Republic of China Aston Pharmacy School Aston UniversityBirminghamUK School of Pharmacy Macao University of Science and TechnologyTaipaMacao

Objectives Older individuals with multimorbidity are at an elevated risk of infection and complications from *** of post-COVID-19 interventions or care models in reducing subsequent adverse outcomes in these individuals have rarely been *** study aims to examine the effectiveness of attending general outpatient within 30 days after discharge from COVID-19 on 1-year survival among older adults aged 85 years or above with *** Retrospective cohort study emulating a randomised target trial using electronic health *** We used data from the Hospital Authority and the department of health in Hong Kong,which provided comprehensive electronic health records,COVID-19 confirmed case data,population-based vaccination records and other individual characteristics for the *** Adults aged 85 years or above with multimorbidity who were discharged after hospitalisation for COVID-19 between January 2020 and August *** Attending a general outpatient within 30 days of last COVID-19 discharge defined the exposure,compared to no outpatient *** outcome measures Primary outcome was all-cause mortality within one *** outcomes included mortality from respiratory,cardiovascular and cancer *** A total of 6183 eligible COVID-19 survivors were included in the *** all-cause mortality rate following COVID-19 hospitalisation was lower in the general outpatient visit group(17.1 deaths per 100 person-year)compared with non-visit group(42.8 deaths per 100 person-year).After adjustment,primary care consultations within 30 days after discharge were associated with a significantly greater 1-year survival(difference in 1-year survival:11.2%,95%CI 8.1%to 14.4%).We also observed significantly better survival from respiratory diseases in the general outpatient visit group(difference in 1-year survival:6.3%,95%CI 3.5%to 8.9%).In a sensitivity analysis for different grace period lengths

关键词： morbidity visit records

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Bronchoalveolar lavage fluid metagenomic next-generation sequencing assay for identifying pathogens in lung cancer patients

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BIOCELL 2024年第4期48卷 623-637页

作者： JIYU WANG HUIXIA LI DEYUAN ZHOU LIHONG BAI KEJING TANG Division of Pulmonary and Critical care Medicine The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina Institute of Pulmonary Diseases Sun Yat-sen UniversityGuangzhouChina department of Pharmacy The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina

Background:For patients with lung cancer,timely identiﬁcation of new lung lesions as infectious or non-infectious,and accurate identiﬁcation of pathogens is very important in improving OS of *** a new auxiliary examination,metagenomic next-generation sequencing(mNGS)is believed to be more accurate in diagnosing infectious diseases in patients without underlying diseases,compared with conventional microbial tests(CMTs).We designed this study toﬁnd out whether mNGS has better performance in distinguishing infectious and non-infectious diseases in lung cancer patients using bronchoalveolar lavageﬂuid(BALF).Materials and Methods:This study was a real-world retrospective review based on electronic medical records of lung cancer patients with bronchoalveolar lavage(BAL)and BALF commercial mNGS testing as part of clinical care from 1 April 2019 through 30 April 2022 at The First Afﬁliated Hospital of Sun Yat-sen University.164 patients were included in this *** were categorized into the pulmonary non-infectious disease(PNID)group(n=64)and the pulmonary infectious disease(PID)group(n=100)groups based onﬁnal ***:BALF mNGS increased the sensitivity rate by 60%compared to CMTs(81%vs.21%,p0.1).Among the patients with PID,bacteria were the most common cause of *** infections occurred in 32%of patients,and Pneumocystis Yersini was most *** with Tyrosine kinase inhibitors(TKIs)therapy possess longer overall survival(OS)than other anti-cancer agents,the difference between TKIs and immuno-checkpoint inhibitors(ICIs)was insigniﬁcant(median OS TKIs *** ***-angiogenic *** ***=76 vs.84 vs.61 vs.58 vs.60).Conclusions:our study indicates that BALF mNGS can add value by improving overall sensitivity in lung cancer patients with potential pulmonary infection,and was outstanding in identifying Pneumocystis *** could be able

关键词： Lung cancer Bronchoalveolar lavage fluid Metagenomic next-generation sequencing Infectious diseases

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The Oral health Status of person with Special Needs in Kumasi

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Open Journal of Stomatology 2024年第1期14卷 14-31页

作者： Ama Agyeibea Amuasi Alexander Oti-Acheampong Victoria N. A. Boadu Lord J. J. Gowans The department Child Oral health & Orthodontics School of Medicine and Dentistry College of Health Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana The department of Oral & Maxillofacial Sciences School of Medicine and Dentistry College of Health Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana The department of Community Dentistry School of Medicine and Dentistry College of Health Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana

Background: The most prevalent non-communicable disease worldwide is oral health-related disease, with dental caries and periodontal conditions being common. Oral health status significantly impacts overall health and quality of life. Barriers to dental care affect children with special needs. This study evaluates the oral health status and treatment requirements of people with special needs. Methodology: This descriptive cross-sectional study in Kumasi, Ghana examined oral health status among people, 121 children with special needs over two months, in June-July 2022. Dental caries, periodontal changes, malocclusion, and trauma were assessed. The data was analyzed using SPSS 20.0. Results: The oral health status among people with special needs in this study was generally moderate, with a range from very good to very poor. The prevalence of dental caries was 37%, with a mean DMFT score of 2.82. Periodontal health showed unsatisfactory indicators such as mobile teeth, poor gingival health, high plaque scores, and the presence of halitosis. Conclusion: This descriptive study aimed to provide baseline data on the oral health status of special needs students in Kumasi, addressing the lack of knowledge in this area. It highlighted the importance of dental care in maintaining good oral health and overall well-being in individuals with special needs. Coordinated efforts by dental professionals are needed to provide dental health education and preventive interventions for these children.

关键词： Special Needs Oral health Dental Caries Periodontal Diseases Malocclusion

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Molecular analysis for diagnosis of Marfan syndrome and Marfan-associated disorders

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Chinese Medical Journal 2011年第6期000卷 930-934页

作者： GAO Ling-gen YAO Xiu-ping ZHANG Lin HUI Ru-tai ZHOU Xian-liang department of Cardiology Fuwai Hospital and Cardiovascular InstituteChinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China department of very important person health care General Hospital of Beijing Armed Police Forces Beijing 100027 China department of very important person health care General Hospital of Chinese People's Armed Police Forces Beijing 100039 China Sino-German Laboratory for Molecular Medicine Key Laboratory for Clinical Cardiovascular Genetics Ministry of Education Fuwai Hospital and Cardiovascular InstituteChinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

Marfan syndrome is a systemic disorder of connective tissue, caused by mutations in the FBN1, TGFBR1 or TGFBR2 genes. This syndrome is characterized by involvement of three major systems, skeletal, ocular, and cardiovascular. The continuing improvements in molecular biology and increasing availability of molecular diagnosis in clinical practice allow recognition of Marfan syndrome in patients with incomplete phenotypes. Additionally, molecular analyses could also be used for preimplantation genetic diagnosis. The identification of a mutation allows for early diagnosis, prognosis, genetic counseling, preventive management of carriers and reassurance for unaffected relatives. The importance of knowing in advance the location of the putative family mutation is highlighted by its straightforward application to prenatal and postnatal screening.

关键词： Marfan syndrome molecular analysis Marfan-associated disorders

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Severe acute respiratory syndrome coronavirus-2-related and imputable deaths in children:results from the French pediatric national registry

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World Journal of Pediatrics 2024年第6期20卷 611-620页

作者： Marguerite Lockhart-Bouron Noemie Vanel Michael Levy Anais R.Briant Etienne Javouhey Sophie Breinig Julia Dina Marion Caseris Francois Angoulvant Stephane Leteurtre Morgan Recher David W.Brossier Univ.Lille CHU LilleULR 2694-METRICS:Evaluation Des Technologies de Sante Et Des Pratiques Medicales59000LilleFrance Pediatric Intensive care Unit CHU de MarseilleMarseilleFrance Pediatric Intensive care Unit CHU Robert-DebreAssistance Publique Hopitaux de ParisParisFrance UniversitéParis-Cite ParisFrance Biostatistics and Clinical Research Unit CHU de Caen Normandie14000CaenFrance Pediatric Intensive care Hospices Civils de LyonLyonFrance Neonatal andPediatric Intensivecare Unit Children's HospitalToulouseFrance Virology department INSERM U1311 DynamicureUniv CAEN NormandieCHU de Caen14000 CaenFrance Medical School Universite Caen Normandie14000 CaenFrance department of Pediatrics CHU Robert-DebréAssistance Publique Hopitaux de ParisParisFrance department Women-Mother-Child Service of PediatricsLausanne University Hospital(CHUV)LausanneSwitzerland Pediatric Intensive care Unit Réanimation Et Soins Intensifs PéediatriquesCHU de CAENAvenue de La Cote de Nacre14000 CaenFrance CHU Sainte Justine Research Center MontréalCanada

Background Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)is responsible for an important mortality rate *** aimed to evaluate the actual imputability of SARS-CoV-2 on the mortality rate associated with SARS-CoV-2-related illnesses in the pediatric intensive care unit(PICU).Secondary objectives were to identify risk factors for *** This national multicenter comparative study comprised all patients under 18 years old with positive SARS-CoV-2 polymerase chain reactions(PCRs)[acute corona virus disease 2019(COVID-19)or incidental SARS-CoV-2 infection]and/or pediatric inflammatory multisystem syndrome(PIMS)recorded in the French PICU registry(PICURe)between September 1,2021,and August 31,*** patients were classified and compared according to their living status at the end of their PICU *** patients were evaluated by four experts in the field of pediatric infectiology and/or pediatric intensive *** imputability of SARS-CoV-2 as the cause of death was classified into four categories:certain,very probable,possible,or unlikely,and was defined by any of the first three *** There were 948 patients included of which 43 died(4.5%).From this,26 deaths(67%)could be attributed to SARS-CoV-2 infection,with an overall mortality rate of 2.8%.The imputability of death to SARS-CoV-2 was considered certain in only one case(O.1%).Deceased patients suffered more often from comorbidities,especially heart disease,neurological disorders,hematological disease,cancer,and *** of the deceased patients were admitted for pediatric inflam-matory multisystem syndrome(PIMS).Mortality risk factors were male gender,cardiac comorbidities,cancer,and acute respiratorydistress *** SARS-CoV-2 mortality in the French pediatric population was *** though the imputability of SARS-Cov-2 on mortality was considered in almost two-thirds of cases,this imputability was considered certain in only one case.

关键词： Death Pediatric intensive care unit SARS-CoV-2

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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Coinfection with Malaria in Selected States in Nigeria

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Advances in Infectious Diseases 2024年第2期14卷 442-455页

作者： Oluwagbemiga Olanrewaju Aina Olufemi Samuel Amoo Kazeem Adewale Osuolale Adewale Kayode Ojogbede Azuka Patrick Okwuraiwe David Ayoola Oladele Adesola Zaidat Musa Tajudeen Akanji Bamidele Celestina Onyinye Okoyenta Abideen Olurotimi Salako Toyosi Yekeen Raheem Ifeoma Eugenia Idigbe Fehintola Anthonia Ige Joseph Ojonugwa Shaibu Gregory Aigbe Ohihoin Kikelomo Wright Bisola Adebayo Hussein Abdu-Razzaq Abdulrahman Ahmad Mustapha Imam Bashir Bello Tambuwal Muhammad Shuaibu Gobir Richard Ikwuogu Christian Tetsola Gloria Patrick-Ferife Nathaniel Enamuotor Mildred Okowa William Nwachukwu Cornelius Ohonsi Magdalene Egede Chinwe Ochu Ehimario Igumbor Oliver Chukwujekwu Ezechi Babatunde Lawal Salako Rosemary Ajuma Audu Biochemistry and Nutrition department Nigerian Institute of Medical Research Lagos Nigeria Centre for Human Virology and Genomics Microbiology Department Nigerian Institute of Medical Research Lagos Nigeria Monitoring and Evaluation Unit Nigerian Institute of Medical Research Lagos Nigeria Public health and Epidemiology department Nigerian Institute of Medical Research Lagos Nigeria Clinical Sciences department Nigerian Institute of Medical Research Lagos Nigeria Molecular Biology and Biotechnology department Nigerian Institute of Medical Research Lagos Nigeria department of Community health & Primary health care Lagos State University College of Medicine Lagos State University Teaching Hospital Lagos Nigeria Research Unit Lagos State Ministry of Health Lagos Nigeria Sokoto State Ministry of health Sokoto Nigeria department of Medical Biochemistry Usmanu Danfodiyo University Sokoto Nigeria Centre for Advanced Medical Research and Training Usmanu Danfodiyo University Sokoto Nigeria Delta State Ministry of health Asaba Nigeria Nigeria Centre for Disease Control Abuja Nigeria Center for Infectious Disease Research Nigerian Institute of Medical Research Lagos Nigeria

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The objective of this study is to determine the burden of co-infection of SARS-CoV-2 and malaria in the general population. Five (5 mLs) of blood samples were collected for SARS-CoV-2 and malaria parasite test. The malaria test was performed using a commercially available one-step malaria antigen Plasmodium falciparum histidine-rich protein 2 (Pf HRP-II) rapid test kit. The results of the study showed that the participants that were coinfected with SARS-CoV-2 IgG and malaria were 13 (2.5%) in Lagos, 1114 (39.1%) in Delta and 49 (2.3%) in Sokoto States. The prevalence of coinfection of SARS-CoV-2 and malaria in urban areas in Lagos, Delta and Sokoto States were 7 (2.2%), 1373 (48.1%), and 5 (0.2%) respectively. In rural areas, the prevalence of coinfection of SARS-CoV-2 and malaria in Lagos, Delta and Sokoto States were 6 (0.3%), 365 (12.8%), and 44 (2.1%) respectively in this study. This suggests that participants in the urban areas were more prone to co-infections than the rural areas in Lagos and Delta states, while it was otherwise in Sokoto State. In conclusion, the co-infection of SARS-CoV-2 and malaria was very high in Delta State compared to the other States. It is important for clinics to screen for both diseases when patients present with symptoms of malaria. This is because the infections have similar symptoms and the public is quick to assume malaria infection without diagnosing for COVID-19 and vice versa.

关键词： SARS-CoV-2 Malaria Coinfection

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Nursing effect of narrative nursing intervention on postoperative patients with severe lung cancer

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World Journal of Clinical Cases 2024年第1期12卷 76-85页

作者： Bin Wen Ying Liu Xiao-Xia Min An-Qi Wang department of Intensive care Tongren Hospital of Wuhan University and Wuhan Third HospitalOptics Valley BranchWuhan 430074Hubei ProvinceChina The First department of Thoracic Oncology Hubei Cancer Hospital Affiliated to Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430079Hubei ProvinceChina department of Emergency Medicine Taizhou First People's HospitalTaizhou 318020Zhejiang ProvinceChina

BACKGROUND Lung cancer is a common disease with high mortality,and psychological support is very important in the diagnosis and treatment of postoperative patients with cancer *** To explore the application effect of the narrative nursing method in postoperative lung cancer patients in the intensive care *** A total of 120 patients diagnosed with lung cancer and experiencing cancer-related pain were randomly allocated into two groups:an observation group and a control group,each consisting of 60 *** control group was given routine analgesic and psychological care,while the research group applied the five-step narrative nursing method based on routine care,comparing the visual analogue scale scores,sleep status,anxiety and depression status,and quality of life of the two groups of patients before and after the *** The pain scores,anxiety scores,and depression scores of the study group were lower than those of the control group after the intervention using the narrative nursing method,and the difference was statistically significant(P<0.05).CONCLUSION Using narrative nursing methods to intervene in patients with lung cancer combined with cancerous pain can help patients to correctly recognize their disease,adjust their mentality,establish confidence,alleviate patients'subjective pain feelings,and improve their adverse emotions.

关键词： Narrative care Lung cancer care unit Pain Quality of life

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Systemic juvenile idiopathic arthritis–associated lung disease: A retrospective cohort study

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World Journal of Clinical Pediatrics 2024年第1期13卷 73-83页

作者： Konstantin E Belozerov Natalia M Solomatina Eugenia A Isupova Alla A Kuznetsova Mikhail M Kostik department of Pediatric Saint-Petersburg State Pediatric Medical UniversitySaint-Petersburg 194100Russia St.Petersburg State Budgetary Institution of health care Children's City Polyclinic No.29 of the Kalininsky District of St.PetersburgSt.Petersburg 195274Russia Research Laboratory of Autoimmune and Autoinflammatory Diseases World-Class Research Centre for Personalized MedicineAlmazov National Medical Research CentreSt.Petersburg 197341Russia

BACKGROUND Lung damage in systemic juvenile arthritis(sJIA)is one of the contemporary topics in pediatric *** previous studies showed the severe course and fatal outcomes in some *** information about interstitial lung disease(ILD)in the sJIA is scarce and limited to a total of 100 *** To describe the features of sJIA patients with ILD in *** In the present retrospective cohort study,information about 5 patients less than 18-years-old with sJIA and ILD were *** diagnosis of sJIA was made according to the current 2004 and new provisional International League of Associations for Rheumatology criteria *** was diagnosed with chest computed tomography with the exclusion of other possible reasons for concurrent lung *** activation syndrome(MAS)was diagnosed with HLH-2004 and 2016 EULAR/ACR/PRINTO Classification Criteria and hScores were calculated during the lung *** The onset age of sJIA ranged from 1 year to 10 *** time interval before ILD ranged from 1 mo to 3 *** disease course was characterized by the prevalence of the systemic features above articular involvement,intensive rash(100%),persistent and very active MAS(hScore range:194-220)with transaminitis(100%),and respiratory symptoms(100%).Only 3 patients(60%)developed a clubbing *** patients(100%)had pleural effusion and 4 patients(80%)had pericardial effusion at the disease *** patients(40%)developed pulmonary arterial ***-related reactions to tocilizumab were observed in 3(60%)of the *** patient with trisomy 21 had a fatal disease *** of the remaining patients had sJIA remission and 2 patients had *** disease improved in 3 patients(75%),but 1 of them had initial deterioration of lung *** patient who has not achieved the sJIA remission had the progressed course of *** cases of hyper-eosinophilia were *** patients(80%)received

关键词： Systemic juvenile arthritis Interstitial lung disease Canakinumab Tocilizumab Interleukin-6 Interleukin-1

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Efficacy of electroacupuncture on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass:a systematic review and Meta-analysis

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Journal of Traditional Chinese Medicine 2024年第1期44卷 1-15页

作者： QIN Xiaoyu WANG Chunai XUE Jianjun ZHANG Jie LU Xiaoting DING Shengshuang GE Long WANG Minzhen the First Clinical Medical College Gansu University of Chinese MedicineLanzhou 730030China department of Anesthesiology Gansu Provincial Hospital of Traditional Chinese MedicineLanzhou 730050China Evidence-based Medicine Center Lanzhou UniversityLanzhou 730030China Institute of Epidemiology and Statistics School of Public HealthLanzhou UniversityLanzhou 730030China

OBJECTIVE:To evaluate the efficacy of electroacupuncture(EA)intervention on myocardial protection and postoperative rehabilitation in patients undergoing cardiac surgery with cardiopulmonary bypass(CPB).METHODS:Eight databases,including Pub Med,Embase,the Cochrane Library,Web of Science,Chinese Bio Medical Literature Database,China National Knowledge Infrastructure Database,Wanfang Data,China Science and Technology Journal Database,and two clinical trial registries,were *** randomized controlled trials(RCTs)related to EA intervention in cardiac surgery with CPB were *** on the inclusion and exclusion criteria,two researchers independently screened articles and extracted *** the quality evaluation,RevMan 5.3 software was used for ***:Fourteen RCTs involving 836 patients were *** with the control treatment,EA significantly increased the incidence of cardiac automatic rebeat after aortic unclamping[relative risk(RR)=1.15,95%confidence interval(CI)(1.01,1.31),Pvery low]expression levels and decreased the malondialdehyde[SMD=-1.62,95%CI(-2.15,-1.09),Pcare unit stay[SMD=-1.

关键词： electroacupuncture cardiopulmonary bypass thoracic surgery myocardial ischaemia-reperfusion injury myocardial protection postoperative rehabilitation Meta-analysis randomized controlled trial

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Risk Factors for Mortality in Acute Kidney Injury in Intensive care Units in Togo

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Open Journal of Nephrology 2024年第1期14卷 37-47页

作者： Eyram Makafui Yoan Yawo Amekoudi Kossi Akomola Sabi Marcel David Keoula Badomta Dolaama Sarakawabalo Assenouwe Tabana Mouzou department of Nephrology Kara University Hospital University of Kara Kara Togo department of Nephrology and Haemodialysis Sylvanus Olympio University Hospital University of Lome Lomé Togo department of Anaesthesia and Intensive care University Hospital of Kara University of Kara Kara Togo

Context: Acute kidney injury (AKI) in intensive care unit (ICU) is common and associated with very high mortality. In Togo, a tropical country with limited resources and only one nephrology department in the north, acute kidney injury seems to be a real tragedy with high mortality. Aims: to determine risk factors for mortality in acute kidney injury in the intensive care units. Methods and Material: We made a multicentric cross sectional study during 6 months in the four referral centers in northern Togo. Univariate and multivariate logistic regression was used to identify factors associated with mortality. Data were analyzed using RStudio 2023.04.1. Results: A total of 12.6% of patients admitted to intensive care had presented with AKI. The mean age was 49.6 ± 17.9. The sex ratio (M/F) was 2.1. Community-acquired AKI was in the majority (67.7%). Oligo anuria was the most frequent functional sign (38.4%). In our series, 81.6% of patients were in KDIGO stages 2 to 3. AKI was organic in 56.2% of cases. Mortality was 44.3%. In multivariate analysis, the main factors predictive of death were: respiratory distress (OR = 2.36;p Conclusions: Acute kidney injury in intensive care is common in northern Togo, and mortality is high. Identification of associated factors should help anticipate prognosis.

关键词： AKI Intensive care Unit Dialysis Epidemiology Togo

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