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1.
Respir Care ; 66(2): 307-315, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32900917

RESUMO

BACKGROUND: Although studies have confirmed the safety and feasibility of early active mobilization, its implementation status is still unsatisfactory. The most important obstacle is ensuring patient safety. Comprehensively assessing the physical condition of patients considered for mobilization is the basis of safety. However, appropriate guidance is lacking. We performed a systematic review to extract and summarize current safety assessment criteria for the early active mobilization of mechanically ventilated patients in the ICU. METHODS: A systematic literature search was conducted using English and Chinese databases according to the PRISMA checklist and guidelines to identify relevant original studies that evaluated safety assessment variables and specific parameters. RESULTS: A total of 24 medium- and high-quality articles involving a total of 4,842 subjects were included in the analysis. Among these studies, there were 15 randomized controlled trials involving 1,777 subjects (888 in the control groups, 889 in the interventional groups) and 9 cohort studies involving 3,065 subjects (1,240 in the control groups, 1,825 in the exposure groups). There were 5 safety assessment criteria, including cardiovascular, respiratory, neurological, musculoskeletal, and other. Within these were 17 different variables and 48 specific parameters. CONCLUSIONS: The safety assessment criteria should focus on cardiac reserve, respiratory reserve, consciousness, and muscle strength. It is especially important to note whether the parameters are stable because parameter stability can be more representative of a patient's condition than absolute values. We provide a flow diagram for clinical safety assessments; however, some limitations exist, and this assessment requires further validation and optimization.


Assuntos
Unidades de Terapia Intensiva , Respiração Artificial , Deambulação Precoce , Humanos , Força Muscular , Segurança do Paciente
2.
J Med Internet Res ; 22(12): e17899, 2020 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-33300884

RESUMO

BACKGROUND: In recent years, there have been many suggestions to use multimedia as a strategy to fully meet the educational needs of patients with peripherally inserted central catheters. However, the potential benefits remain unreliable in the literature. OBJECTIVE: In this study, we identified the potential benefits of multimedia-based home catheter management education in patients with peripherally inserted central catheters and discussed the clinical implications. METHODS: We performed systematic searches of the PubMed, Cochrane Library, Embase Ovid, Medline, BioMed Central-cancer (BMC-cancer), ScienceDirect, and Google Scholar databases without date constraints until November 30, 2019. The methodological quality of the eligible studies was appraised using the Cochrane risk of bias tool. Narrative synthesis of the study findings was conducted. RESULTS: A total of 6 intervention studies met the inclusion criteria, including 3 randomized controlled trials and 3 case-control studies/quasi-experimental studies. The studies included a total of 355 subjects, including a total of 175 in the multimedia groups and 180 in the control groups. We identified 4 potential benefits to patients: (1) improved knowledge, (2) increased satisfaction, (3) reduced incidence of catheter-related complications, and (4) reduced number of cases of delayed care after complications. CONCLUSIONS: The current systematic review highlights the potential benefits of multimedia-based home catheter management education for patients with peripherally inserted central catheters.


Assuntos
Cateterismo Periférico/métodos , Serviços de Assistência Domiciliar/normas , Multimídia/normas , Estudos de Casos e Controles , Feminino , Humanos , Masculino
3.
Int J Nurs Stud ; 111: 103768, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32971449

RESUMO

BACKGROUND: Sexual dysfunction is a common long-term complication of cervical cancer and its treatment. However, due to traditional Chinese culture, there are few studies on interventions to improve sexual function in China. OBJECTIVES: To evaluate the effectiveness of a nurse-led positive psychology intervention on sexual function, depression and subjective well-being amongst postoperative patients with early-stage cervical cancer. DESIGN: A randomized controlled trial. SETTINGS AND METHODS: Patients who had undergone radical hysterectomy for early-stage cervical cancer and were followed up in gynaecological clinics were recruited via convenience sampling from three tertiary hospitals in Chongqing, China. Patients who met the inclusion criteria and agreed to participate (N = 91) were randomly assigned to a nurse-led positive psychology intervention (intervention group, n = 46) or usual care (control group, n = 45). The Female Sexual Function Index, Self-rating Depression Scale and Index of Well-being were used to assess sexual function, depression and subjective well-being, respectively, at baseline and 3 and 6 months after the intervention. Data were analysed by the chi-square test, Mann-Whitney U test, t-test and Pearson correlation analysis. RESULTS: Compared with participants in the control group, participants in the intervention group showed significant improvements in sexual function (mean difference [MD]: -3.95, P = 0.005 at 3 months post-intervention; MD: -4.36, P = 0.001 at 6 months post-intervention). In addition, at 3 and 6 months after the intervention, the number of patients with improvements in their levels of depression and well-being in the intervention group was higher than that in the control group (P<0.05). The Pearson correlation analysis results showed that there was a negative correlation between sexual function and level of depression in patients (r =-0.612, P<0.001) and that sexual function was positively correlated with subjective well-being (r = 0.638, P<0.001). CONCLUSION: The intervention group experienced significant improvements in sexual function, depression and subjective well-being. These findings suggest that a nurse-led positive psychology intervention should be implemented for postoperative patients with early-stage cervical cancer.


Assuntos
Neoplasias do Colo do Útero , China , Depressão/prevenção & controle , Feminino , Humanos , Papel do Profissional de Enfermagem , Psicologia Positiva , Neoplasias do Colo do Útero/cirurgia
4.
Cancer Manag Res ; 12: 4321-4333, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32606928

RESUMO

Purpose: Hypoxia-induced changes are primarily activated in patients with hepatocellular carcinoma (HCC) and long-term sorafenib exposure, thereby reducing the sensitivity to the drug. Aquaporin-3 (AQP3), a member of the aquaporin family, is a hypoxia-induced substance that affects the chemosensitivity of non-hepatocellular tumors. However, its expression and role in the sensitivity of hypoxic HCC cells to sorafenib-induced apoptosis remain unclear. The purpose of this study was to detect changes in AQP3 expression in hypoxic HCC cells and to determine whether these changes alter the sensitivity of these cells to sorafenib. Materials and Methods: Huh7 and HepG2 hypoxic cell models were established and AQP3 expression was detected using quantitative real-time polymerase chain reaction (qPCR) and Western blotting. Furthermore, the role of AQP3 in cell sensitivity to sorafenib was evaluated via flow cytometry, Western blotting, and a CCK-8 assay. Results: The results of qPCR and Western blotting showed that AQP3 was overexpressed in the Huh7 and HepG2 hypoxic cell models. Furthermore, AQP3 protein levels were positively correlated with hypoxia-inducible factor-1α (HIF-1α) levels. Compared with cells transfected with lentivirus-GFP (Lv-GFP), hypoxic cells transfected with lentivirus-AQP3 (Lv-AQP3) were less sensitive to sorafenib-induced apoptosis. However, the sensitivity to the drug increased in cells transfected with lentivirus-AQP3RNAi (Lv-AQP3RNAi). Akt and Erk phosphorylation was enhanced in Lv-AQP3-transfected cells. Compared with UO126 (a Mek1/2 inhibitor), LY294002 (a PI3K inhibitor) attenuated the AQP3-induced insensitivity to sorafenib observed in hypoxic cells transfected with Lv-AQP3. Combined with LY294002-treated cells, hypoxic cells transfected with Lv-AQP3RNAi were more sensitive to sorafenib. Conclusion: The study results show that AQP3 is a potential therapeutic target for improving the sensitivity of hypoxic HCC cells to sorafenib.

5.
J Contin Educ Nurs ; 50(3): 121-126, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30835322

RESUMO

BACKGROUND: This multicenter cross-sectional study sought to determine the knowledge, attitudes, and practices regarding the use of physical restraints by Chinese nurses in intensive care units (ICUs) of tertiary hospitals. METHOD: A scale technique was used to measure the knowledge, attitudes, and practices of 383 RNs from eight tertiary hospitals in Chongqing, China. RESULTS: A total of 383 valid questionnaires were returned, for a response rate of 89.49%. Approximately 8.1% of the nurses were male, 67.1% had a bachelor's degree or above, and 55.09% were ICU specialists. The average age was 28.62 years (SD = 4.56). The mean scores were 74.33 of 111 (SD = 9.552), 24.41 of 40 (SD = 4.872), and 65.66 of 130 (SD = 20.880) regarding knowledge, attitudes, and nursing practices, respectively. For the attitude scale, the scores of nurses who were certified ICU specialists and had extensive working experience were higher than those with less experience; the difference was statistically significant (p < .05). CONCLUSION: Results indicated that nurses employed in the ICUs of tertiary hospitals in Chongqing, China, have relatively insufficient knowledge, comparatively incorrect attitudes, and unreasonable means of practicing physical restraint. Continuing education should focus strongly on the relationship between physical restraint and unplanned extubation, and guidelines on physical restraint urgently need to be developed. [J Contin Educ Nurs. 2019;50(3):121-126.].


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Atitude do Pessoal de Saúde , Enfermagem de Cuidados Críticos/métodos , Conhecimentos, Atitudes e Prática em Saúde , Recursos Humanos de Enfermagem no Hospital/psicologia , Restrição Física/psicologia , Adulto , China , Estudos Transversais , Feminino , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Centros de Atenção Terciária
6.
Kardiol Pol ; 77(2): 207-216, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30740643

RESUMO

BACKGROUND: Due to the myopathic adverse events of statins, safer alternatives are being studied. Bempedoic acid (ETC-1002) is a novel low-density lipoprotein cholesterol (LDL-C)-lowering agent, currently under trial in hypercholesterolaemic patients. AIM: To investigate the tolerability and efficacy of ETC-1002 in hypercholesterolaemic patients through a systematic review of published randomised controlled trials (RCTs). METHODS: Five databases were searched for RCTs that investigated the safety and efficacy of ETC-1002 in hypercholesterol-aemic patients. The retrieved search results were screened, and then data were extracted and analysed (as mean difference [MD] or odds ratio [OR]) using the RevMan software. RESULTS: Five RCTs (625 hypercholesterolaemic patients) were identified. ETC-1002 was superior to placebo in terms of percent-age changes from baseline in serum levels of LDL-C (MD -26.58, 95% confidence interval [CI] -35.50 to -17.66, p < 0.0001), non-high-density lipoprotein cholesterol (MD -21.54, 95% CI -28.48 to -14.6, p < 0.00001), and apolipoprotein-B (MD -15.97, 95% CI -19.36 to -12.57, p < 0.0001). When compared to ezetimibe, ETC-1002 was superior in reducing LDL-C (-30.1 ± 1.3 vs. -21.1 ± 1.3). Regarding safety, ETC-1002 did not increase the risk of all adverse events (OR 0.58, 95% CI 0.37-0.91, p = 0.02) and arthralgia (OR 0.32, 95% CI 0.13-0.81, p = 0.02) compared to placebo. All other adverse events including myalgia, headache, and urinary tract infections were similar between ETC-1002 and placebo groups. The evidence certainty in the assessed outcomes was moderate to high except for lipoprotein(a), free fatty acids, and very low-density lipoprotein particle number (very low certainty). CONCLUSIONS: ETC-1002 is a safe and effective lipid-lowering agent and may be a suitable alternative in statin-intolerant pa-tients. Well-designed studies are needed to explore the long-term safety and efficacy of ETC-1002 in these patients.


Assuntos
Ácidos Dicarboxílicos/uso terapêutico , Ácidos Graxos/uso terapêutico , Hipercolesterolemia/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Idoso , LDL-Colesterol/sangue , Ácidos Dicarboxílicos/efeitos adversos , Ezetimiba/efeitos adversos , Ezetimiba/uso terapêutico , Ácidos Graxos/efeitos adversos , Feminino , Humanos , Hipercolesterolemia/sangue , Hipolipemiantes/efeitos adversos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
7.
Zhongguo Zhong Xi Yi Jie He Za Zhi ; 36(8): 942-945, 2016 08.
Artigo em Chinês | MEDLINE | ID: mdl-30640989

RESUMO

Objective To observe the prevention of acupoint massage for the occurrence of deep venous thrombosis (DVT) of various risk degrees after gynecologic laparoscopic surgery. Methods Using Autar deep vein risk assessment scale, patients undergoing gynecological laparoscopic surgery from June 2014 to December 2014 were assessed one day before surgery and 24 h after surgery. Patients at moderate and high risks were recruited as subjects in this research by blocking method, 72 in the moderate risk group and 34 in the high risk group. Patients in the two groups were then randomly assigned to the control group and the test group respectively. Conventional care plus intermittent limb pressure treatment were performed to patients in the control group. Conventional care plus acupoint massage [Zusanli (ST36) , Shangjuxu (ST37) , Liangqiu (ST34) , Yinshi (ST33) , Futo (ST32) ] were performed to patients in the test group. Red blood cell ( RBC) aggregation index and popliteal vein blood flow velocity were detected before surgery, at day 1 and 5 after surgery. The postoperative thrombosis rate was statistically analyzed. Results DVT of lower limbs occurred in 4 cases of this study, 2 in the moderate risk group and 2 in the high risk group. The incidence of DVT of lower limbs was 5. 6% (2R6) in the moderate risk control group and 0. 0% (0/36) in the moderate risk test group, and it was 11. 8%(2/17) in the high risk control group and 0. 0% (0/17) in the high risk test group (P <0. 05). The incidence of thrombosis in recruited patients was significantly lower in the test group than in the control group (P <0. 05). Compared with before surgery, RBC aggregation index obviously increased and popliteal vein blood flow velocity significantly decreased in recruited patients at day 1 after surgery (P <0. 05). Compared with day 1 after surgery, RBC aggregation index obviously increased and popliteal vein blood flow velocity significantly decreased in all patients at day 5 after surgery (P <0. 05). Compared with the control group, RBC aggregation index obviously decreased and popliteal vein blood flow velocity significantly increased in the test group (P <0. 05). Conclusion As for moderate risk and high risk patients evaluated by Autar scale, conventional care and assisted acupoint massage was conducive to preventing postoperative DVT.


Assuntos
Pontos de Acupuntura , Procedimentos Cirúrgicos em Ginecologia , Trombose Venosa , Feminino , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Humanos , Laparoscopia , Massagem , Trombose Venosa/etiologia , Trombose Venosa/prevenção & controle
8.
Med Oncol ; 28(3): 804-9, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20405249

RESUMO

Dicer, the key enzyme in the RNAi pathway, is misregulated in tumor tissues. The altered expression of Dicer is associated with clinical characteristics in patients with cancer. Liver carcinoma and adjacent non-neoplastic tissues were obtained from 36 patients with hepatocellular carcinoma (HCC) undergoing surgery. Expressions of Dicer mRNA were evaluated using the Real-time reverse transcription-PCR in 36 liver carcinoma tissues and 36 adjacent histologically non-cancerous liver tissues. Dicer mRNA levels were evaluated in relation to age, sex, tumor number, tumor size, tumor stage, and distant metastasis. Dicer mRNA level was significantly lower in malignant tissues than in the corresponding non-neoplastic tissues in 34 of the 36 patients with HCC (94.4%). The Dicer expression level was not associated with clinical characteristics, including age, sex, tumor number, tumor size, tumor stage, or distant metastasis in HCC cases. These results demonstrate that Dicer is significantly down-regulated in HCC, suggesting that reduced expression of Dicer may play an important role during the process of hepatocarcinogenesis.


Assuntos
Carcinoma Hepatocelular/metabolismo , Regulação para Baixo , Neoplasias Hepáticas/metabolismo , Ribonuclease III/biossíntese , Adulto , Idoso , Western Blotting , Carcinoma Hepatocelular/patologia , Feminino , Humanos , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , RNA Mensageiro/análise , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa
9.
Lin Chuang Er Bi Yan Hou Ke Za Zhi ; 20(19): 875-7, 2006 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-17168112

RESUMO

OBJECTIVE: To assess the clinical and pathological features of the patients with ENT adenoid cystic carcinoma (ENTACC) who presented with hard lump, and to detect its prognosis. METHOD: A retrospective analysis was performed on 9 patients with ENTACC by their clinical data. RESULT: The period from the occurrence of primary symptoms to definite diagnosis was 4 years and 3 months on average. All patients were followed up from 6 months to 15 years. All of the cases relapsed after operation and radiotherapy. Five patients died, among which 3 died with lung metastases, 2 with local lymphatic metastases, 1 with bone metastases and 1 with encephalic diffusion. The other 4 cases still survive. The longest survival period with tumor was 6 years and 3 months. CONCLUSION: The pathological result of these 9 cases were all salivary gland derived adenoid cystic carcinoma of solid type. It was mainly characterized by the development of ENT hard lump. All of the patients should be diagnosed in time. Extensive excision and postoperative radiotherapy are needed at the first time. The tumor of solid histological pattern appears with much poorer prognosis compared with that of other histological pattern.


Assuntos
Carcinoma Adenoide Cístico , Neoplasias das Glândulas Salivares , Adulto , Idoso , Carcinoma Adenoide Cístico/diagnóstico , Carcinoma Adenoide Cístico/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/patologia
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