Pre-operative pulmonary assessment for patients with hip fracture.

Hip fracture is a common injury among the elderly. Although patients who receive hip fracture surgery carry the best functional recovery compared to other treatment modalities, the presence of postoperative pulmonary complications, such as atelectasis, pneumonia, and pulmonary thromboembolism, may contribute to increased length of hospital stay, perioperative morbidity, and mortality. This review aims to provide evidence-based recommendations for preoperative assessment and perioperative strategies to reduce the risk of pulmonary complications after hip fracture surgery. Clinical assessment and basic laboratory results are sufficient to stratify the risk of postoperative pulmonary complications. Well-documented risk factors for pulmonary complications include advanced age, poor general health status, current infections, pre-existing cardiopulmonary diseases, hypoalbuminemia, and impaired renal function. Apart from optimizing the patient's medical conditions, interventions such as lung expansion maneuvers and thromboprophylaxis have been proven to be effective in reducing the risk of pulmonary complications after hip fracture surgery.

Knowledge, Attitude and Preventive Practice on Dementia Care among Primary Health Professionals in Macao.

The Macao Dementia Policy was recognized by Alzheimer Disease International as the 27th globally and one of the highest stage 5 to develop dementia friendly community and primary health professionals are in a pivotal position to enhance community-based dementia prevention and care quality. This study aimed to investigate the knowledge, attitude and preventive practice on dementia care among primary health professionals in Macao. A specially designed 30-item questionnaire was developed and validated for the study. The Content Validity Index (CVI) and Cronbach's α of the questionnaire were 0.973 and 0.808. The questionnaires were distributed to all 375 primary health professionals from 8 Health Centers throughout Macao and 234 valid questionnaires (62.4%) were returned. The score for dementia care knowledge was 87.02±14.01; attitude was 69.52±5.83; preventive practice was 77.88±13.18, of which doctors (79.89±13.77) was significantly higher (t=2.29, p=0.023) than nurses (75.91±12.33). There were positive relationships between preventive practice and attitude (r=0.163, p=0.014), and age (r=0.212, p=0.002), and a negative relationship between knowledge and age (r=-0.139, p=0.040). These findings have significant implications that most primary health professionals in Macao had sufficient knowledge, a positive attitude and appropriate preventive practice on dementia care. However, enhanced dementia education to improve knowledge and preventive practice was a strong agenda for the training for senior staff and nurses.

Apolipoproteins A-I and B in non-insulin-dependent diabetes mellitus.

In recent years apolipoproteins A-I and B examinations have been performed on patients with coronary artery disease as a better predictor of the severity of atherosclerosis. In the present study, 21 treated male and 22 treated female patients with non-insulin-dependent diabetes mellitus (NIDDM) were examined and compared with controls of the same sex, age and body mass (23 males, 21 females). Cholesterol, triglyceride, LDL-cholesterol in male and female patients with NIDDM were significantly higher than in male and female controls. HDL-cholesterol in male and female patients with NIDDM was not different from those of male and female controls. Apolipoproteins A-I and B in male and female patients with NIDDM were higher than in male and female controls. [Apolipoproteins A-I (g/L) male 1.40 +/- 0.21 vs 1.25 +/- 0.15, p less than 0.005; female 1.56 +/- 0.23 vs 1.42 +/- 0.24, p less than 0.025. Apolipoproteins B (g/L) male 1.29 +/- 0.30 vs 0.97 +/- 0.22, p less than 0.001; female 1.34 +/- 0.34 vs 0.98 +/- 0.35, p less than 0.001.] Discrepancy between the higher apolipoprotein A-I and the normal HDL-cholesterol in in NIDDM supports the theory of altered composition of HDL particles in diabetic patients. The controversy between the higher apolipoprotein A-I and the higher incidence of atherosclerosis in patients with NIDDM makes the clinical usefulness of this laboratory measurement doubtful in these patients.