RESUMEN
ABSTRACT: Colchicine reduces atherothrombotic cardiovascular events in coronary artery disease because of its anti-inflammatory effect. However, the effects of the other anti-inflammatory drugs in coronary artery disease remain unclear. This study included 132 patients aged 18-80 years who completed the planned percutaneous coronary interventions and were treated with aggressive secondary prevention strategies for 4 weeks. The subjects were randomly assigned to 1 of the following treatment groups for 4 weeks: (1) control: no additional intervention; (2) colchicine: 0.5 mg once a day; (3) tranilast: 0.1 g thrice a day; or (4) oridonin: 0.5 g thrice a day. The primary outcome was the percentage change in high-sensitivity C-reactive protein (hsCRP) levels at the end of 4 weeks. In total, 109 patients completed the study. The mean age was 58.33 years, 81 (74.31%) were male, and 28 (25.69%) were female. The percentage changes in hsCRP after 4 weeks of treatment were -11.62%, -48.28%, -21.60%, and -7.81%, in the control, colchicine, tranilast, and the oridonin groups, respectively. Compared with the control group, only the colchicine group showed significantly greater reduction in hsCRP levels ( P = 0.022). In targeted proteomic analysis, proteins associated with neutrophil activation (azurocidin, myeloperoxidase, and myeloblastin), platelet aggregation (glycoprotein VI), and endothelial damage (galectin-3) were reduced with colchicine therapy. These results show that of 3 anti-inflammatory drugs only colchicine could reduce hsCRP in patients after percutaneous coronary interventions.
Asunto(s)
Enfermedad de la Arteria Coronaria , Diterpenos de Tipo Kaurano , Intervención Coronaria Percutánea , ortoaminobenzoatos , Humanos , Masculino , Femenino , Persona de Mediana Edad , Proteína C-Reactiva/metabolismo , Enfermedad de la Arteria Coronaria/tratamiento farmacológico , Proyectos Piloto , Proteómica , Antiinflamatorios/efectos adversos , Colchicina/efectos adversos , Intervención Coronaria Percutánea/efectos adversos , Resultado del TratamientoRESUMEN
AIMS: To survey the types of Electronic Nursing Records used and to explore nurses' perceptions in the hospitals in Henan Province, China. BACKGROUND: There are few studies about status of electronic nursing documents from nurses' view. METHOD: A cross-sectional study of 3,586 nurses using a web-based questionnaire was conducted. RESULTS: Approximately 98% of the nurses were college graduates or had higher degrees, with 46% of the nurses managed more than nine beds per nurse each day. About 27% spent more than two hours daily writing records with a further 38% spending between 1 and 2 hr. However, only 52% realized professional nursing records should be archived and fewer than 80% knew the importance and significance of preserving fundamental nursing records. CONCLUSION: Although nurses' educational level in Henan is high, the younger age of them (i.e., less experience) and heavy workload may lead to inferior quality of ENR. Nurses' awareness of the importance and legal significance of documents needs improvement. IMPLICATION FOR NURSING MANAGEMENT: Our results may provide detailed evidence of the time consuming as well as nurses' knowledge of, abilities in, and opinions about record-keeping in developed countries and bring potential clinical implications for the nursing managers worldwide.
Asunto(s)
Registros Electrónicos de Salud/normas , Enfermeras y Enfermeros/psicología , Percepción , Adulto , Actitud del Personal de Salud , China , Estudios Transversales , Documentación/métodos , Documentación/normas , Registros Electrónicos de Salud/tendencias , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermeras y Enfermeros/tendencias , Encuestas y Cuestionarios , Carga de Trabajo/normasRESUMEN
BACKGROUND: Allopurinol, a xanthine inhibitor that lowers uric acid concentration, has been proven to reduce inflammation and oxidative stress in patients with cardiovascular disease. However, it is unknown whether these beneficial effects translate into favorable plaque modiï¬cation in acute coronary syndromes (ACS). This study aimed to investigate whether allopurinol could improve coronary plaque stabilization using coronary computed tomography angiography (CCTA). METHODS: This was a prospective, single-center, randomized, double-blind clinical trial began in March 2019. A total of 162 ACS patients aged 18-80 years with a blood level of high-sensitivity C-reactive protein (hsCRP) â> â2 âmg/L were included. The subjects were randomly assigned in a 1:1 ratio to receive either allopurinol sustained-release capsules (at a dose of 0.25 âg once daily) or placebo for 12 months. The plaque analysis was performed at CCTA. The primary efficacy endpoint was the change in low-attenuation plaque volume (LAPV) from baseline to the 12-month follow-up. RESULTS: Among 162 patients, 54 in allopurinol group and 51 in placebo group completed the study. The median follow-up duration was 14 months in both groups. Compared with placebo, allopurinol therapy did not signiï¬cantly alter LAPV (-13.4 â± â3.7 â% vs. -17.8 â± â3.6 â%, p â= â0.390), intermediate attenuation plaque volume (-16.1 â± â3.0 â% vs. -16.2 â± â2.9 â%, p â= â0.992), dense calciï¬ed plaque volume (12.2 â± â13.7 â% vs. 9.7 â± â13.0 â%, p â= â0.894), total atheroma volume (-15.2 â± â3.2 â% vs. -16.4 â± â3.1 â%, p â= â0.785), remodeling index (2.0 â± â3.9 â% vs. 5.4 â± â3.8 â%, p â= â0.536) or hsCRP levels (-73.6 [-91.6-17.9] % vs. -81.2 [-95.4-47.7] %, p â= â0.286). CONCLUSIONS: Our ï¬ndings suggest that allopurinol does not improve atherosclerotic plaque stability or inï¬ammation in ACS.