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1.
Estima (Online) ; 19(1): e0421, jan.-dez. 2021.
Article in Portuguese | BDENF - Nursing | ID: biblio-1178058

ABSTRACT

Objetivos:identificar na literatura científica o conhecimento produzido sobre lesões por fricção em idosos. Métodos: trata-se de uma revisão integrativa de literatura (2014-2019), realizada a partir de busca nas bases de dados/plataformas National Library of Medicine, Biomedical Answers e Biblioteca Virtual em Saúde, com descritores e os operadores booleanos "and" e "or". Resultados: a partir da busca bibliográfica, seleção e análise, oito artigos compuseram a amostra. Para lesão por fricção em idosos emergiram quatro pilares do cuidado: manutenção da homeostase orgânica e tissular com foco na nutrição e hidratação apropriada; evitar traumas na pele senil, proporcionando um ambiente seguro com dispositivos adequados; e a sistematização da assistência e educação em saúde do cuidado com a pele do idoso. Conclusão: como mecanismos de prevenção, encontram-se a realização da prevenção primária por meio de um plano de cuidados singular e as atividades de educação em saúde, focadas nos fatores de risco e nas vulnerabilidades, minimizando danos e complicações


Subject(s)
Wounds and Injuries , Aged , Friction , Geriatric Nursing
2.
BMC Psychol ; 9(1): 67, 2021 Apr 30.
Article in English | MEDLINE | ID: mdl-33931117

ABSTRACT

BACKGROUND: Despite peer involvement having a positive impact on help-seeking behavior, there is a lack of a scale quantifying the possibility of an individual intervening upon noticing peers who show signs of depression. The aims of this study were to (1) develop a bystander intervention scale for depression that assesses the likelihood of university students intervening when a peer shows signs of depression based on the theory of bystander intervention, (2) identify the underlying factors contributing to the behavior, and (3) explore the socio-demographic correlates of the scale. METHODS: The proposed scale, the Bystander Intervention Scale for Depression (BISD), is a 17-item self-reported questionnaire that was developed based on existing bystander intervention theory and inputs from mental health experts. Data was collected as part of a larger study to evaluate the effectiveness of an anti-stigma intervention amongst university students from a local university. A total of 392 participants were recruited. Exploratory factor analyses were performed to identify the underlying factor structure. Multiple linear regressions were conducted to explore the socio-demographic correlates of the scale. RESULT: Four key factors were identified for the proposed scale: (1) Awareness of depression among peers; (2) Vigilance towards possible symptoms of depression; (3) Knowledge on how to intervene; (4) Acceptance of responsibility to intervene. Having experience in the mental health field was associated with all factors while having family members or friends with mental illness was associated with all factors except for knowledge on how to intervene. Students of older age were associated with higher vigilance towards possible symptoms of depression and knowledge on how to intervene. Those of non-Chinese ethnicity were associated with acceptance of responsibility to intervene. CONCLUSION: This study provides a preliminary tool to assess bystander intervention in depression amongst university students. This study identifies sub-groups of the student population that require more education to intervene with depressed peers and also informs the development of future strategies.


Subject(s)
Depression , Universities , Aged , Demography , Humans , Singapore , Students
3.
Endocr Pract ; 27(5): 408-412, 2021 May.
Article in English | MEDLINE | ID: mdl-33934751

ABSTRACT

OBJECTIVE: To investigate the added value of 1/3 radius (1/3R) for the diagnosis of osteoporosis by spine and hip sites and its correlation with prevalent fractures and predicted fracture risk. METHODS: Fracture Risk Assessment Tool (FRAX) scores for hip and major osteoporotic fractures (MOF) with/without trabecular bone score were considered proxy for fracture risk. The contribution of 1/3R to risk prediction was depicted via linear regression models with FRAX score as the dependent variable-first only with central and then with radius T-score as an additional covariate. Significance of change in the explained variance was compared by F-test. RESULTS: The study included 1453 patients, 86% women, aged 66 ± 10 years. A total of 32% (n = 471) were osteoporotic by spine/hip and 8% (n = 115) by radius only, constituting a 24.4% increase in the number of subjects defined as osteoporotic (n = 586, 40%). Prior fracture prevalence was similar among patients with osteoporosis by spine/hip (17.4%) and radius only (19.1%) (P = .77). FRAX prediction by a regression model using spine/hip T-score yielded explained variance of 51.8% and 49.9% for MOF and 39.8% and 36.4% for hip (with/without trabecular bone score adjustment, respectively). The contribution of 1/3R was statistically significant (P < .001) and slightly increased the explained variance to 52.3% and 50.4% for MOF and 40.9% and 37.4% for hip, respectively. CONCLUSION: Reclassification of BMD results according to radius measurements results in higher diagnostic output. Prior fractures were equally prevalent among patients with radius-only and classic-site osteoporosis. FRAX tool performance slightly improved by incorporating radius BMD. Whether this approach may lead to a better fracture prediction warrants further prospective evaluation.


Subject(s)
Hip Fractures , Osteoporosis , Osteoporotic Fractures , Absorptiometry, Photon , Aged , Bone Density , Female , Hip Fractures/epidemiology , Humans , Male , Middle Aged , Osteoporosis/diagnostic imaging , Osteoporosis/epidemiology , Osteoporotic Fractures/epidemiology , Radius/diagnostic imaging , Risk Assessment , Risk Factors
4.
Endocr Pract ; 27(5): 443-448, 2021 May.
Article in English | MEDLINE | ID: mdl-33934753

ABSTRACT

OBJECTIVE: Meal intake is sometimes reduced in hospitalized patients. Meal-time insulin administration can cause hypoglycemia when a meal is not consumed. Inpatient providers may avoid ordering meal-time insulin due to hypoglycemia concerns, which can result in hyperglycemia. The frequency of reduced meal intake in hospitalized patients remains inadequately determined. This quality improvement project evaluates the percentage of meals consumed by hospitalized patients with insulin orders and the resulting risk of postmeal hypoglycemia (blood glucose [BG] <70 mg/dL, <3.9 mmol/L). METHODS: This was a retrospective quality improvement project evaluating patients with any subcutaneous insulin orders hospitalized at a regional academic medical center between 2015 and 2017. BG, laboratory values, point of care, insulin administration, diet orders, and percentage of meal consumed documented by registered nurses were abstracted from electronic health records. RESULTS: Meal consumption ≥50% was observed for 85% of meals with insulin orders, and bedside registered nurses were accurate at estimating this percentage. Age ≥65 years was a risk factor for reduced meal consumption (21% of meals 0%-49% consumed, P < .05 vs age < 65 years [12%]). Receiving meal-time insulin and then consuming only 0% to 49% of a meal (defined here as a mismatch) was not rare (6% of meals) and increased postmeal hypoglycemia risk. However, the attributable risk of postmeal hypoglycemia due to this mismatch was low (4 events per 1000) in patients with premeal BG between 70 and 180 mg/dL. CONCLUSION: This project demonstrates that hospitalized patients treated with subcutaneous insulin have a low attributable risk of postmeal hypoglycemia related to inadequate meal intake.


Subject(s)
Hyperglycemia , Hypoglycemia , Aged , Blood Glucose , Humans , Hypoglycemia/chemically induced , Hypoglycemia/epidemiology , Hypoglycemic Agents/adverse effects , Insulin/adverse effects , Meals , Retrospective Studies
5.
Croat Med J ; 62(2): 154-164, 2021 Apr 30.
Article in English | MEDLINE | ID: mdl-33938655

ABSTRACT

AIM: To assess the correlations of B regulatory cells (Bregs) and monocyte subsets in peripheral blood with the National Institutes of Health (NIH)-consensus-defined clinical manifestations of chronic graft-vs-host disease (cGvHD), in an attempt to establish their role as cellular biomarkers. METHODS: This multidisciplinary prospective study enrolled adult cGVHD patients treated in the University Hospital Center Zagreb and University of Zagreb School of Medicine. Immunophenotypic subpopulations of CD24highCD38high Bregs (CD27-, CD27+, and total) and monocyte (classical, intermediate, and non-classical) counts were correlated with demographic, transplant, and cGVHD-related data. Bivariate correlation analysis was performed to evaluate the correlations between Bregs and monocytes subsets and cGVHD organ involvement, as well as cGVHD severity and immunosuppression intensity. RESULTS: Twenty-two adult patients (54.5% female) with cGVHD were enrolled. The median (range) age was 44.5 years (24-65). All patients were transplanted for hematologic malignancies and 40.9% had severe NIH cGVHD global score. The median time from cGVHD diagnosis to the analysis was 16.6 months (0-176). The organ most frequently affected with cGVHD were the eyes (68.2%), skin (45.5%), lungs (45.5%), and liver (40.9%). Lower total and CD27-Bregs counts were correlated with worse cGVHD severity, higher immunosuppression intensity, and lung cGVHD, in terms of cell count, but also with skin cGVHD, in terms of percentages. Patients with liver and joint/fascia cGVHD had a lower percentage of non-classical monocytes and patients with more severe global NIH score had a higher classical monocytes count. CONCLUSION: Different organs affected by cGVHD are differently associated with different subpopulations of Bregs and monocytes.


Subject(s)
Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Adult , Aged , Chronic Disease , Female , Humans , Male , Middle Aged , Monocytes , Prospective Studies , United States , Young Adult
6.
Int. j. clin. health psychol. (Internet) ; 21(1): 198-198, ene.-abr. 2021. tab, graf
Article in English | IBECS | ID: ibc-194909

ABSTRACT

BACKGROUND/OBJECTIVE: The objective of the study was to elucidate the underlying mechanism through which basic personality dimensions predict indicators of psychological functioning during the COVID-19 pandemic, including subjective well-being and perceived stress. As a personality characteristic highly contextualized in stressful circumstances, resilience was expected to have a mediating role in this relationship. METHOD: A sample of 2,722 Slovene adults, aged from 18 to 82 years filled in the Big Five Inventory, the Connor-Davidson Resilience Scale, the Perceived Stress Scale, and the Mental Health Continuum. A path analysis with the Bootstrap estimation procedure was performed to evaluate the mediating effect of resilience in the relationship between personality and psychological functioning. RESULTS: Resilience fully or partially mediated the relationships between all the Big Five but extraversion with subjective well-being and stress experienced at the beginning of the COVID-19 outburst. Neuroticism was the strongest predictor of less adaptive psychological functioning both directly and through diminished resilience. CONCLUSIONS: Resilience may be a major protective factor required for an adaptive response of an individual in stressful situations such as pandemic and the associated lockdown


ANTECEDENTES/OBJETIVO: El objetivo fue dilucidar el mecanismo subyacente a través del cual las dimensiones básicas de la personalidad predicen indicadores del funcionamiento psicológico durante la pandemia de COVID-19, incluido el bienestar subjetivo y el estrés percibido. Como característica de la personalidad altamente contextualizada en circunstancias estresantes, se esperaba que la resiliencia tuviera un papel mediador en esta relación. MÉTODO: Una muestra de 2.722 adultos eslovenos (18-82 años), completó el Big Five Inventory, la Connor-Davidson Resilience Scale, la Perceived Stress Scale y el Mental Health Continuum. Se realizó un análisis de ruta con el procedimiento de estimación Bootstrap para evaluar el efecto mediador de la resiliencia en la relación entre la personalidad y el funcionamiento psicológico. RESULTADOS: La resiliencia medió total o parcialmente las relaciones entre los Cinco Grandes, y la extraversión con bienestar subjetivo y el estrés experimentado, al comienzo del estallido de COVID-19. El neuroticismo fue el predictor más fuerte de un funcionamiento psicológico menos adaptativo, tanto directamente como a través de la disminución de la capacidad de resiliencia. CONCLUSIONES: La resiliencia puede ser un factor de protección importante y requerido para una respuesta adaptativa de un individuo en situaciones estresantes como la pandemia y el confinamiento asociado


Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Resilience, Psychological , Personality/physiology , Coronavirus Infections/psychology , Pneumonia, Viral/psychology , Pandemics , Personality Inventory/standards , Psychometrics/methods , Neuroticism/physiology
7.
Int. j. clin. health psychol. (Internet) ; 21(1): 185-185, ene.-abr. 2021. tab, graf
Article in English | IBECS | ID: ibc-ET6-1881

ABSTRACT

BACKGROUND/OBJECTIVE: The aim of the study was to examine the factor structure and psychometric properties of the Spanish version of the Mini-Mental Adjustment to Cancer Scale (Mini-MAC) in a large sample of patients with non-metastatic, resected cancer. METHODS: Prospective, observational, multicenter study for which 914 patients were recruited from 15 Spanish hospitals. Exploratory and confirmatory factor analyses, validity and reliability analyses were conducted. RESULTS: Factor-analytic results indicated a 4-factor structure of the Spanish version of the Mini-MAC. Three subscales have psychometric properties similar to those of Helplessness, Anxious preoccupation, and Cognitive avoidance of the original the Mini-MAC. The Fighting spirit and the Fatalism subscales were combined on the Positive attitude scale. The four factor-derived scale scores exhibited acceptable accuracy for individual measurement purposes, as well as stability over time in test-retest assessments at 6 months. Validity assessments found meaningful relations between the derived scale scores, and Brief Symptom Inventory depression and anxiety scores and Functional Assessment of Chronic Illness Therapy spiritual well-being scores. CONCLUSIONS: The Spanish version of the Mini-MAC provides reliable and valid measures for patients with non-metastatic, resected cancer, and results corroborate the instrument's cross-cultural validity


ANTECEDENTES/OBJETIVO: El objetivo de este estudio fue analizar las propiedades psicométricas de la versión Española del Mini-Mental Adjustment to Cancer Scale (Mini-MAC) en pacientes con cáncer resecado, no metastásico. MÉTODO: Estudio multicéntrico, prospectivo y observacional con 914 pacientes reclutados en 15 hospitales de España. Se llevaron a cabo análisis factorial exploratorio y confirmatorio, así como análisis de la validez y fiabilidad de las puntuaciones de la escala. RESULTADOS: Los resultados de los análisis factoriales sugieren que la estructura más apropiada para la versión española del Mini-MAC es la de cuatro factores. Tres subescalas derivadas de esta estructura tienen propiedades psicométricas similares a la escala original: Desesperanza, Preocupación ansiosa y Evitación cognitiva. Las subescalas Espíritu de lucha y Fatalismo se combinaron en la escala Actitud positiva. Las puntuaciones en las cuatro escalas mostraron una fiabilidad aceptable para su utilización en la evaluación individual, así como estabilidad a lo largo del tiempo en evaluaciones test-retest a los seis meses. Se obtuvieron evidencias de validez en forma de relaciones significativas con las escalas de ansiedad y depresión del BSI, y de bienestar espiritual del FACIT. CONCLUSIONES: La versión Española del Mini-MAC proporciona puntuaciones fiables y válidas para evaluar las estrategias de afrontamiento en pacientes con cáncer y los resultados añaden evidencia a favor de la validez transcultural del instrumento


Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Neoplasms/psychology , Surveys and Questionnaires/standards , Adaptation, Psychological , Prospective Studies , Psychometrics , Factor Analysis, Statistical , Reference Values , Reproducibility of Results , Spain , Attitude to Health
8.
Washington; Organización Panamericana de la Salud; abr 14, 2021. 25 p.
Non-conventional in Spanish | LILACS | ID: biblio-1177781

ABSTRACT

Desde la actualización epidemiológica publicada por la OPS/OMS el 11 de marzo de 2021 hasta el 13 de abril de 2021, fueron notificados 6.182.423 casos confirmados adicionales de COVID-19, incluidas 161.007 defunciones en la región de las Américas, lo que representa un aumento de 11% de casos y de defunciones. Durante el mismo periodo, Bermuda, Bonaire, Curazao y Uruguay presentaron un incremento >50% en el número de casos y defunciones.


Subject(s)
Humans , Middle Aged , Aged , Aged, 80 and over , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Epidemiological Monitoring , Americas/epidemiology , Indigenous Peoples
9.
BMC Surg ; 21(1): 174, 2021 Mar 31.
Article in English | MEDLINE | ID: mdl-33789664

ABSTRACT

BACKGROUND: Lymph node metastasis (LNM) plays a vital role in the determination of clinical outcomes in patients with gastric neuroendocrine tumor (G-NET). Preoperative identification of LNM is helpful for intraoperative lymphadenectomy. This study aims to investigate risk factors for LNM in patients with G-NET. METHODS: We performed a retrospective study involving 37 patients in non-LNM group and 82 patients in LNM group. Data of demographics, preoperative lab results, clinical-pathological results, surgical management, and postoperative situation were compared between groups. Significant parameters were subsequently entered into logistic regression for further analysis. RESULTS: Patients in LNM group exhibited older age (p = 0.011), lower preoperative albumin (ALB) (p = 0.003), higher carcinoembryonic antigen (CEA) (p = 0.020), higher International normalized ratio (p = 0.034), longer thrombin time (p = 0.018), different tumor location (p = 0.005), higher chromogranin A positive rate (p = 0.045), and higher Ki-67 expression level (p = 0.002). Logistic regression revealed ALB (p = 0.043), CEA (p = 0.032), tumor location (p = 0.013) and Ki-67 (p = 0.041) were independent risk factors for LNM in G-NET patients. CONCLUSIONS: ALB, CEA, tumor location, and Ki-67 expression level correlate with the risk of LNM in patients with G-NET.


Subject(s)
Lymphatic Metastasis , Neuroendocrine Tumors , Stomach Neoplasms , Aged , Humans , Neuroendocrine Tumors/pathology , Neuroendocrine Tumors/surgery , Retrospective Studies , Risk Factors , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery
10.
Gan To Kagaku Ryoho ; 48(3): 367-369, 2021 Mar.
Article in Japanese | MEDLINE | ID: mdl-33790159

ABSTRACT

A 72-year-old woman was admitted to our hospital because of symptoms of bleeding diathesis such as hematuria and purpura. A blood test revealed disseminated intravascular coagulation(DIC). Upper gastrointestinal endoscopy showed advanced gastric cancer. Bone marrow aspiration cytology demonstrated diffuse hyperplasia of large atypical cells, and metastasis of the epithelial tumor was suspected on immunohistochemical examination. She was diagnosed with disseminated carcinomatosis of the bone marrow associated with gastric cancer accompanied by DIC. She was treated with weekly infusion of methotrexate 100 mg/m2 plus 5-fluorouracil 600 mg/m2 for 4 courses; and she completely recovered from DIC. She received oral tegafur/gimeracil/oteracil as an outpatient. However, DIC recurred 126 days after the initial chemotherapy, and 5-fluorouracil plus cisplatin was administered subsequently. After 1 course, she died 166 days after the initial chemotherapy. Although the prognosis of patients with disseminated carcinomatosis of the bone marrow associated with gastric cancer accompanied by DIC is extremely poor, this case shows that secession of DIC and prognostic improvement by chemotherapy could occur. Chemotherapy could be considered a potentially effective treatment in this case.


Subject(s)
Bone Marrow Neoplasms , Disseminated Intravascular Coagulation , Peritoneal Neoplasms , Stomach Neoplasms , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Marrow , Bone Marrow Neoplasms/complications , Bone Marrow Neoplasms/drug therapy , Disseminated Intravascular Coagulation/drug therapy , Disseminated Intravascular Coagulation/etiology , Female , Humans , Neoplasm Recurrence, Local , Stomach Neoplasms/complications , Stomach Neoplasms/drug therapy
11.
Gan To Kagaku Ryoho ; 48(3): 397-399, 2021 Mar.
Article in Japanese | MEDLINE | ID: mdl-33790167

ABSTRACT

A 75-year-old man presented to a local clinic with anal pain, and a palpable anal tumor on was found on digital examination of the rectum. A biopsy led to the diagnosis of neuroendocrine carcinoma. Besides the anal tumor, an right-inguinal lymph node was revealed on computed tomography(CT). Positron emission tomography-CT showed abnormal uptake in the 2 regions. He was diagnosed with lymph node metastases from anal canal carcinoma, and an abdominoperineal resection was performed. The resected specimen included the anal canal tumor with a size of 27×18 mm in diameter. On immunohistochemistry, the anal canal tumor was strongly positive for synaptophysin and positive for chromogranin A, with a Ki- 67 positivity index of 70%. After the surgery, he was administered chemotherapy with 4 courses of cisplatin and CPT-11. One year after the surgery, CT revealed lymph node recurrence. Therefore, cisplatin and CPT-11 therapy was repeated. After 11 courses of the cisplatin and CPT-11 treatment, tumor regrowth was still detected. The treatment protocol was changed to an amrubicin monotherapy regimen. However, the patient's general condition worsened after the therapies, and he died 38 months after the surgery.


Subject(s)
Anus Neoplasms , Carcinoma, Neuroendocrine , Aged , Anal Canal , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Anus Neoplasms/drug therapy , Anus Neoplasms/surgery , Carcinoma, Neuroendocrine/drug therapy , Carcinoma, Neuroendocrine/surgery , Humans , Male , Neoplasm Recurrence, Local
12.
Gan To Kagaku Ryoho ; 48(3): 410-412, 2021 Mar.
Article in Japanese | MEDLINE | ID: mdl-33790171

ABSTRACT

A 67-year-old man was admitted to our hospital because of nausea, anorexia and tarry stool. In the blood examination, serum α-fetoprotein(AFP)level was 1,650 ng/mL, and the upper gastrointestinal endoscopy showed a large hemorrhage tumor at the gastric body. Abdominal enhanced computed tomography(CT)showed a solitary mass in segment 4 of the liver. We performed distal gastrectomy, and administered S-1 plus cisplatin therapy. After 13 months, abdominal CT showed complete response for the metastatic tumor according to the Response Evaluation Criteria in Solid Tumors. Because of adverse events, S-1 monotherapy was administered from postoperative month 23. The patients survived for 66 months with no recurrence.


Subject(s)
Liver Neoplasms , Stomach Neoplasms , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cisplatin/therapeutic use , Gastrectomy , Humans , Liver Neoplasms/drug therapy , Liver Neoplasms/surgery , Male , Neoplasm Recurrence, Local , Stomach Neoplasms/drug therapy , Stomach Neoplasms/surgery , alpha-Fetoproteins
13.
Gan To Kagaku Ryoho ; 48(3): 428-430, 2021 Mar.
Article in Japanese | MEDLINE | ID: mdl-33790177

ABSTRACT

BACKGROUND AND PURPOSE: Simulation computed tomography colonography(sCTC), which combines CTC and 3-dimensional vascular imaging, is popular for the surgery of colorectal cancer. We experience anomaly, called arc of Riolan(aR), rarely but its definition and details are unclear. Using sCTC, we identified aR and investigated the simulation of aR-conserving high ligation. PATIENT AND METHOD: The patients were 3 cases of sigmoid colorectal cancer with aR in 369 patients who underwent sCTC before colorectal cancer surgery. We identified the running morphology of aR. And we classified Griffiths' point as presence(P)and absence(A). Narrow or mesh-shaped artery which were ischemic risk factors of intestinal tract was P groups and normal artery was A groups in the marginal artery of splenic flexure. We simulated aR-conserving lymph node dissection using sCTC. RESULT: Case 1. The patient was 60-year-old man with rectal cancer, cT4aN1M0, Stage Ⅲa. The running morphology of aR was between the left branch of middle colic artery(MCA lt)and LCA. Griffiths point: P. Surgical simulation was D3 lymph node dissection with preservation of aR and high ligation of IMA. Pathological findings was pT3N1M0, Stage Ⅲa. Case 2. The patient was 65-year-old woman with sigmoid colon cancer, cT3N2M0, Stage Ⅲb. The running morphology of aR was between MCA lt and IMA. Griffiths point: P. Surgical simulation was D3 lymph node dissection with preservation of aR and high ligation of IMA. Pathological findings was pT3N2M0, Stage Ⅲb. Case 3. The patient was 75-year-old woman with sigmoid colon cancer, cT1bN0M0, Stage Ⅰ. The running morphology of aR was between first jejunal artery and IMA. Griffiths point: A. Surgical simulation was D3 lymph node dissection with preservation of aR and high ligation of IMA. Pathological findings was pT1bN0M0, Stage Ⅲb. CONCLUSION: Using sCTC, we could identify the various running morphology of aR and simulate aR-conserving lymph node dissection in high ligation.


Subject(s)
Colonography, Computed Tomographic , Laparoscopy , Rectal Neoplasms , Aged , Female , Humans , Ligation , Lymph Node Excision , Male , Mesenteric Artery, Inferior/diagnostic imaging , Mesenteric Artery, Inferior/surgery , Middle Aged , Rectal Neoplasms/surgery
14.
Gan To Kagaku Ryoho ; 48(3): 434-436, 2021 Mar.
Article in Japanese | MEDLINE | ID: mdl-33790179

ABSTRACT

A 70-year-old man was admitted to our hospital with acute abdominal pain. Abdominal CT showed a 6-cm-sized tumor near the third portion of the duodenum, and a duodenal GIST was suspected. Although the abdominal pain was intense and the tumor was suspected to be ruptured, the vital signs were stable; therefore, we initially planned to perform an elective surgery. However, because the pain could not be controlled, the surgery was performed on the 6th day of hospitalization. The tumor appeared to be a duodenal GIST because it was pulling the third portion of the duodenum inwards. It had a strong tendency to infiltrate the surrounding organs; therefore, forced resection of the right colon, which is the surrounding organ, was performed. Pathological findings showed that the resected specimen was a desmoid tumor and the surgical margins were negative. The postoperative course 1 year after surgery was favorable, and no tumor recurrence occurred. We report a case of desmoid tumor, which caused acute abdominal pain.


Subject(s)
Fibromatosis, Abdominal , Fibromatosis, Aggressive , Abdominal Pain/etiology , Aged , Duodenum , Fibromatosis, Abdominal/complications , Fibromatosis, Abdominal/surgery , Fibromatosis, Aggressive/complications , Fibromatosis, Aggressive/surgery , Humans , Male , Neoplasm Recurrence, Local
15.
Gan To Kagaku Ryoho ; 48(3): 443-445, 2021 Mar.
Article in Japanese | MEDLINE | ID: mdl-33790182

ABSTRACT

This is the case of a 72-year-old man in whom multiple colorectal cancers including rectal and appendiceal cancers and synchronous S3 liver metastases were observed in 2014, and resection was performed in 2 stages. In 2017, a single recurrence was found in the liver S8, and he underwent a liver S8 sub-segmental resection. Implantation of a CV port for postoperative chemotherapy was planned. At the time of insertion, the catheter was punctured from the exterior portion of the left subclavian vein to avoid the pinch-off syndrome wherein the catheter is crushed between the clavicle and the first rib. Subsequently, FOLFOX therapy was started, but it was discontinued because of allergic symptoms, which appeared during the third course. Two years after the CV port was implanted, a catheter fracture was found on a chest X-ray performed during a regular visit. Since the detached catheter did not fall into the vein, it was possible to remove the port under fluoroscopy. When a catheter is implanted, even under ultrasound guidance, it is considered important to always keep in mind the possibility of a catheter fracture and to detect and respond to it early.


Subject(s)
Catheterization, Central Venous , Central Venous Catheters , Liver Neoplasms , Aged , Catheters, Indwelling , Humans , Liver Neoplasms/drug therapy , Male , Neoplasm Recurrence, Local
16.
J Glob Health ; 11: 05007, 2021 Mar 01.
Article in English | MEDLINE | ID: mdl-33791096

ABSTRACT

Background: Respiratory syncytial virus (RSV) and influenza are prevalent seasonal community viruses. Although not completely understood, SARS-CoV-2 may have the same means of transmission. Preventive social measures aimed at preventing SARS-CoV-2 spread could impact transmission of other respiratory viruses as well. The aim of this study is to report the detection of RSV and influenza during the period of social distancing due to COVID-19 pandemic in a heavily affected community. Methods: Prospective study with pediatric and adult populations seeking care for COVID-19-like symptoms during the fall and winter of 2020 at two hospitals in Southern Brazil. RT-PCR tests for SARS-CoV-2, influenza A (Flu A), influenza B (Flu B) and respiratory syncytial virus (RSV) was performed for all participants. Results: 1435 suspected COVID-19 participants (1137 adults, and 298 children). were included between May and August. Median age was 37.7 years (IQR = 29.6-47.7), and 4.92 years (IQR = 1.96-9.53), for the adult and child cohorts, respectively. SARS-CoV-2 was positive in 469 (32.7%) while influenza and RSV were not detected at all. Conclusions: Measures to reduce SARS-CoV-2 transmission likely exerted a huge impact in the spread of alternate respiratory pathogens. These findings contribute to the knowledge about the dynamics of virus spread. Further, it may be considered for guiding therapeutic choices for these other viruses.


Subject(s)
/prevention & control , Influenza A virus/isolation & purification , Influenza B virus/isolation & purification , Influenza, Human/diagnosis , Respiratory Syncytial Virus Infections/diagnosis , Respiratory Syncytial Viruses/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , /epidemiology , Child , Child, Preschool , Female , Hospitals , Humans , Infant , Influenza, Human/transmission , Male , Middle Aged , Prospective Studies , Respiratory Syncytial Virus Infections/transmission , Seasons , Young Adult
17.
Indian J Med Res ; 153(1 & 2): 115-125, 2021.
Article in English | MEDLINE | ID: mdl-33818468

ABSTRACT

Background & objectives: The COVID-19 pandemic emerged as a major public health emergency affecting the healthcare services all over the world. It is essential to analyze the epidemiological and clinical characteristics of patients with COVID-19 in different parts of our country. This study highlights clinical experience in managing patients with COVID-19 at a tertiary care centre in northern India. Methods: Clinical characteristics and outcomes of consecutive adults patients admitted to a tertiary care hospital at Chandigarh, India, from April 1 to May 25, 2020 were studied. The diagnosis of SARS-CoV-2 infection was confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) on throat and/or nasopharyngeal swabs. All patients were managed according to the institute's consensus protocol and in accordance with Indian Council of Medical Research guidelines. Results: During the study period, 114 patients with SARS-CoV-2 infection were admitted. The history of contact with COVID-19-affected individuals was available in 75 (65.8%) patients. The median age of the patients was 33.5 yr (13-79 yr), and there were 66 (58%) males. Of the total enrolled patients, 48 (42%) were symptomatic. The common presenting complaints were fever (37, 77%), cough (26, 54%) and shortness of breath (10, 20.8%). Nineteen (17%) patients had hypoxia (SpO2<94%) at presentation and 36 (31%) had tachypnoea (RR >24). Thirty four (29.8%) patients had an accompanying comorbid illness. Age more than 60 yr and presence of diabetes and hypertension were significantly associated with severe COVID-19 disease. Admission to the intensive care unit (ICU) was needed in 18 patients (52%), with three (2.6%) patients requiring assisted ventilation. Mortality of 2.6 per cent (3 patients) was observed. Interpretation & conclusions: Majority of the patients with COVID-19 infection presenting to our hospital were young and asymptomatic. Fever was noted only in three-fourth of the patients and respiratory symptoms in half of them. Patients with comorbidities were more vulnerable to complications. Triaged classification of patients and protocol-based treatment resulted in good outcomes and low case fatality.


Subject(s)
/epidemiology , Pandemics , Tertiary Care Centers/statistics & numerical data , Adolescent , Adult , Aged , Child , Demography , Female , Humans , India/epidemiology , Male , Middle Aged , Young Adult
18.
Am J Phys Med Rehabil ; 100(5): 419-423, 2021 05 01.
Article in English | MEDLINE | ID: mdl-33819922

ABSTRACT

OBJECTIVE: The aim of the study was to determine the prevalence of deep venous thrombosis detected by duplex screening and risk factors associated with deep venous thrombosis in patients with COVID-19 upon admission to an inpatient rehabilitation hospital. DESIGN: This is a retrospective review. SETTING: The setting is three freestanding inpatient rehabilitation hospitals operating as one system. PARTICIPANTS: The participants are consecutive patients with a diagnosis of COVID-19 admitted to an inpatient rehabilitation hospital without a diagnosis of deep venous thrombosis or screening duplex ultrasound prior to transfer. INTERVENTIONS: A duplex ultrasound of lower limbs was performed upon admission to inpatient rehabilitation hospital. OUTCOME MEASURES: Primary outcome was the percentage of admission patients with a lower limb deep venous thrombosis. Secondary factors included potential risk factors for a positive screen for deep venous thrombosis. RESULTS: A lower limb deep venous thrombosis was diagnosed in 22% (25/113) of the patients tested, with eight patients (7.1%) having a proximal deep venous thrombosis. Risk factors for screening positive for a deep venous thrombosis included being male, younger, and having been on a ventilator during the acute illness. CONCLUSIONS: The high rate of deep venous thrombosis observed in these patients suggests that the risk of venous thromboembolic disorders after severe COVID-19 illness is considerable and surveillance measures of such patients should be undertaken.


Subject(s)
/complications , Hospitalization , Hospitals, Rehabilitation , Venous Thrombosis/diagnosis , Venous Thrombosis/epidemiology , Adult , Aged , Aged, 80 and over , Female , Humans , Lower Extremity/blood supply , Lower Extremity/diagnostic imaging , Male , Middle Aged , Retrospective Studies , Risk Factors , Ultrasonography, Doppler, Duplex , Young Adult
19.
Am J Phys Med Rehabil ; 100(5): 435-438, 2021 05 01.
Article in English | MEDLINE | ID: mdl-33819924

ABSTRACT

ABSTRACT: Physical training in Parkinson disease improves motor performance, alleviates nonmotor symptoms, and enhances cognition and quality of life. Nonetheless, adherence to exercise is low and travel costs and time may limit participation and compliance. Training at home can help avoid these burdens and, as needed during the recent global pandemic (COVID-19), reinforce social distancing and reduce the risk of infection. However, training at home requires motivation and self-control and telerehabilitation is time-consuming for both patient and therapist. In recent years, there is growing use of virtual reality and exergaming to increase motivation and adherence for exercising with evidence of improvements in mobility and balance after using virtual reality in the clinic. Here, a novel telerehabilitation training program using a treadmill-virtual reality system for simultaneous training of two patients with Parkinson disease in their homes is described. Remote monitoring software enabled visual and auditory communication with the two patients, allowing the trainer to adapt the settings remotely and provide feedback. Participants received weekly training sessions over 1 yr. The findings show high adherence to training, increased walking duration throughout the sessions, and increased patient confidence, gait speed, and mobility. Training multiple participants simultaneously was feasible, enabling an individualized treatment approach while conserving therapist time.


Subject(s)
Parkinson Disease/rehabilitation , Telerehabilitation , Virtual Reality , Aged , Female , Humans , Male , Middle Aged
20.
BMJ ; 373: n826, 2021 04 07.
Article in English | MEDLINE | ID: mdl-33827854

ABSTRACT

OBJECTIVE: To describe a novel England-wide electronic health record (EHR) resource enabling whole population research on covid-19 and cardiovascular disease while ensuring data security and privacy and maintaining public trust. DESIGN: Data resource comprising linked person level records from national healthcare settings for the English population, accessible within NHS Digital's new trusted research environment. SETTING: EHRs from primary care, hospital episodes, death registry, covid-19 laboratory test results, and community dispensing data, with further enrichment planned from specialist intensive care, cardiovascular, and covid-19 vaccination data. PARTICIPANTS: 54.4 million people alive on 1 January 2020 and registered with an NHS general practitioner in England. MAIN MEASURES OF INTEREST: Confirmed and suspected covid-19 diagnoses, exemplar cardiovascular conditions (incident stroke or transient ischaemic attack and incident myocardial infarction) and all cause mortality between 1 January and 31 October 2020. RESULTS: The linked cohort includes more than 96% of the English population. By combining person level data across national healthcare settings, data on age, sex, and ethnicity are complete for around 95% of the population. Among 53.3 million people with no previous diagnosis of stroke or transient ischaemic attack, 98 721 had a first ever incident stroke or transient ischaemic attack between 1 January and 31 October 2020, of which 30% were recorded only in primary care and 4% only in death registry records. Among 53.2 million people with no previous diagnosis of myocardial infarction, 62 966 had an incident myocardial infarction during follow-up, of which 8% were recorded only in primary care and 12% only in death registry records. A total of 959 470 people had a confirmed or suspected covid-19 diagnosis (714 162 in primary care data, 126 349 in hospital admission records, 776 503 in covid-19 laboratory test data, and 50 504 in death registry records). Although 58% of these were recorded in both primary care and covid-19 laboratory test data, 15% and 18%, respectively, were recorded in only one. CONCLUSIONS: This population-wide resource shows the importance of linking person level data across health settings to maximise completeness of key characteristics and to ascertain cardiovascular events and covid-19 diagnoses. Although this resource was initially established to support research on covid-19 and cardiovascular disease to benefit clinical care and public health and to inform healthcare policy, it can broaden further to enable a wide range of research.


Subject(s)
/epidemiology , Cardiovascular Diseases/epidemiology , Electronic Health Records , Medical Record Linkage , Adolescent , Adult , Aged , Cardiovascular Diseases/diagnosis , Child , Child, Preschool , Cohort Studies , England/epidemiology , Female , Hospitalization/statistics & numerical data , Humans , Infant , Infant, Newborn , Male , Middle Aged , Primary Health Care/statistics & numerical data , Young Adult
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