Tag: nevin manimala

J Cancer Res Ther. 2024 Apr 1;20(2):509-521. doi: 10.4103/jcrt.jcrt_1031_23. Epub 2024 Apr 30.

ABSTRACT

The incidence of thromboembolic events (TEs) in non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs) has rarely been reported. The MEDLINE, EMBASE, and the Cochrane Library databases were searched. The primary outcome was the incidence of TEs, and the secondary outcome was the relationship between TEs and overall survival (OS) following ICI therapy. A subgroup analysis of TE incidents was performed according to the TE type and combination regimens. The I2 statistic was used to determine the heterogeneity, and funnel plots and Egger’s test were used to assess publication bias. A total of 16,602 patients with NSCLC in 63 experimental arms were included in the analysis. The rate of TEs ranged from 0.1% to 13.8%, and the pooled overall incidence of all-grade TEs was 3% (95% confidence interval [CI], 2%-4%). The pooled rate of high-grade TEs was 1% (95% CI, 1%-2%). The venous and arterial TE rates were 3% (95% CI, 2%-4%) and 1% (95% CI, 1%-2%), respectively. Patients who received immunotherapy + chemoradiotherapy had the highest incidence of TEs (7%). The TE pooled rate was higher in patients treated with combined ICIs than in those treated with mono ICIs (4% vs. 2%). The OS was lower in patients with TEs than in those without TEs (hazard ratio, 1.4; 95% CI, 1.02%-1.92%). The incidence of TEs in NSCLC patients treated with ICIs was reasonable. Nonetheless, clinicians must be aware of potential thrombotic complications and treat them promptly.

PMID:38687920 | DOI:10.4103/jcrt.jcrt_1031_23

Altern Ther Health Med. 2024 Apr 26:AT9713. Online ahead of print.

ABSTRACT

OBJECTIVE: The current study aimed to analyze the postoperative intracranial infection in patients with senile cerebral tumors treated by craniotomy.

METHODS: This retrospective study included 116 patients with senile cranial tumors admitted and treated in our Hospital from January 2019 to January 2021. The patients were assigned to an observation group and a conventional group, by different nursing interventions, with 58 patients in each. Patients in both groups were treated with craniotomy, in which patients in the conventional group were given routine nursing. In contrast, patients in the observation group were provided with predictive nursing interventions. Predictive nursing interventions encompass personalized care plans, early identification of infection risk factors, and tailored prophylactic measures. A comparative analysis of the nursing intervention effect, self-management of the patients, and impact on the physical and mental health of the patients was performed between the two groups, with statistical significance set at P < .05. The Short Form Health Survey (SF-36) is a widely used and well-validated questionnaire designed to measure health-related quality of life and is adopted in this study to assess the quality of life of patients.

RESULTS: The number of intracranial infection cases in the observation group (4) was significantly less than in the conventional group (14), and the incidence of intracranial infection in the observation group (6.90%) was significantly reduced than in the conventional group (24.14%) (P < .05). Moreover, the effective rate of patients in the observation group (96.55%) was significantly higher than that in the conventional group (77.59%) (P < .05). The quality of life of patients in both groups improved, and the SF-36 score of patients in the observation group (70.25±7.18) was significantly higher than that of the conventional group (60.18±5.54) (P < .05). The total satisfaction of patients in the observation group (98.28%) was significantly higher than that of the conventional group (82.76%) (P < .05). Predictive nursing interventions minimize the incidence of postoperative complications, particularly intracranial infections, leading to improved treatment outcomes, enhanced quality of life, and increased patient satisfaction.

CONCLUSION: The provision of predictive nursing care to patients with senile cranial tumors treated with craniotomy can effectively reduce the incidence of postoperative intracranial infection, and the nursing effect is better for patients with or without intracranial infection, which can significantly contribute to the quality of life quality improvement and effectively enhance patients’ satisfaction. Further research is imperative to evaluate and promote the practice as a significant toolkit in clinical practice. Future investigations should focus on the enduring impact of predictive nursing interventions in senile cerebral tumor patients post-craniotomy, unraveling sustained benefits over an extended period. The study’s findings underscore the potential for transformative nursing practices in craniotomy for senile cranial tumors, advocating for the integration of predictive nursing interventions to enhance patient safety, satisfaction, and overall well-being.

PMID:38687866

Altern Ther Health Med. 2024 Apr 26:AT10366. Online ahead of print.

ABSTRACT

OBJECTIVE: Myocardial infarction, coronary heart disease is one of the serious types, come on urgent, case fatality rate is high, especially the front wall or extensive anterior wall myocardial infarction, easy to merge cardiac insufficiency, arrhythmia, even in patients with sudden death will happen, and life-threatening. The aim of this study was to investigate the effects of HOPE management mode on cardiac function, quality of life and in-hospital cardiovascular adverse events in patients with myocardial infarction.

METHODS: 118 patients with myocardial infarction hospitalized in our hospital from January 2020 to March 2022 were randomly divided into study group (n=59) and control group (n=59) and carried out a prospective study. The study group was treated with HOPE management mode, the control group was treated with conventional intervention. The LVEF, GRACE, quality of life were evaluated before intervention, 1 week after, 1 month and 3 months after intervention to evaluate the improvement of clinical symptoms, cardiac function and quality of life of patients.

RESULTS: The LVEF were increased from (42.94±2.38) % to (47.03±2.62) % in control group and from (43.51±2.45) to (52.94±3.09) in sudy group; the quality of life were increased from (42.08±7.44) points to (57.00±4.49) points in control group and (43.76±6.68) points to (69.42±8.03) points in sudy group; the GRACE score were increased from (152.10±14.52) points to (110.10±9.73) points in control group and (153.63±15.11) points to (81.71±10.21) points in sudy group, the difference were statistically significant (P < .05). All indicators in study group were better than those in control group at each time point after intervention (P < .05). Kaplan-Meier curve showed that the incidence of adverse cardiovascular events in the study group was lower than that in the control group within 3 months. Within 90 days of hospitalization, the incidence of adverse cardiovascular events were 28.81% in the control group, which was higher than 15.25% in the study group (P < .05). Kaplan-meier observation showed that the incidence of adverse cardiovascular events in control group was significantly higher than that in study group (χ2=5.586, P = .018).

CONCLUSIONS: The HOPE management model can effectively improve the cardiac function and quality of life of patients with myocardial infarction, and reduce GRACE scores and the incidence of in-hospital cardiovascular adverse events, which can as a comprehensive approach to improve clinical outcomes and enhance the quality of life for patients with myocardial infarction.

PMID:38687863

Altern Ther Health Med. 2024 Apr 26:AT9627. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aims to assess and compare the outcomes of modified radical surgery, preserving the nipple-areola complex, against radical mastectomy in patients with triple-negative breast cancer. Emphasis is placed on the clinical significance of this comparison, including its potential impact on patient outcomes, quality of life, and healthcare resources.

METHODS: Relevant literature from January 2017 to January 2022 was searched in the following databases: PubMed, Embase, MEDLINE, Science Citation Index, Web of Science, China National Knowledge Internet, CCD, and CSPD with keywords. The electric search yielded 613 relevant articles, including 351 from Pubmed, 187 from Embase, 5 from MEDLINE, 21 from CNKI, 4 from CCD, and 45 from CSPD. After duplicate screening, 185 items were eliminated, leaving 428 articles. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with RevMan 5.3, and sensitivity analysis, cumulative meta-analysis, and publication bias analysis were also performed. A total of 613 relevant articles were collected from the above databases, among which 428 articles remained after the initial screening and were further screened based on the established inclusion and exclusion criteria. The efficacy of modified radical surgery and breast-conserving surgery in the treatment of early breast cancer was assessed by analyzing outcome indicators, including recurrence rate, distant metastatic rate, and three-year survival rate. The methods section details a systematic approach to data collection and analysis, specifying the databases and time frame for the literature search and the statistical tools used for the meta-analysis. The selection process, from the initial number of articles to the final inclusion based on defined criteria, is transparent, ensuring the study’s methodological robustness in evaluating the efficacy of surgeries for early breast cancer.

RESULTS: Finally, ten articles were found to match the criteria and included in this study. According to the meta-analysis, there was no statistically significant difference between the breast-conserving therapy (BCT) and modified radical mastectomy (MRM) groups in terms of the recurrence rate (OR = 0.76, 95%CI = 0.39, 1.55, P > .05) and distant metastatic rate (OR = 0.81, 95%CI = 0.46, 1.31, P > .05). Nevertheless, the three-year survival rate was 85.2% in the BCT group and 91.7% in the MRM group; a statistically significant difference was observed in the three-year survival rate (OR = 1.47, 95%CI = 1.01, 2.37, P = .03) between the BCT and MRM groups. Accordingly, breast-conserving surgery and modified radical surgery produced comparable clinical outcomes for the treatment of early breast cancer.

CONCLUSION: In the treatment of early breast cancer, breast-conserving surgery has the advantages of less bleeding, fewer clinical complications, and favorable cosmetic outcomes compared with modified radical surgery. Furthermore, patients with breast-conserving surgery showed comparable recurrence and distant metastatic rates to those with modified radical surgery in postoperative follow-up, which, therefore is a suitable treatment option for the widespread recommendation. The study’s findings hold significant clinical relevance, implying that while BCT remains a viable option, MRM may offer a survival advantage. This insight empowers both patients and clinicians in making informed, personalized treatment decisions tailored to individual circumstances.

PMID:38687862

Altern Ther Health Med. 2024 Apr 26:AT10043. Online ahead of print.

ABSTRACT

OBJECTIVE: This meta-analysis aims to evaluate the comparative clinical efficacy of photodynamic therapy (PDT) versus other non-surgical treatments in managing peri-implantitis.

METHODS: Computer searches were conducted in databases including PubMed, The Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang for randomized controlled trials (RCTs) on the clinical efficacy of Photodynamic Therapy (PDT) compared to other non-surgical methods in the treatment of peri-implantitis. The search period spanned from May 2000 to May 2023. Based on inclusion and exclusion criteria, literature was screened, data extracted, and the quality of the studies was assessed. Included studies were publicly published randomized controlled experiments focusing on the combination of photodynamic therapy and non-surgical methods compared to non-surgical methods alone in the treatment of peri-implantitis. Articles with insufficient or unclear definitions of peri-implantitis cases were excluded from the selected studies. Statistical analysis was performed using RevMan 5.3 software.

RESULTS: Nine RCTs were included for Meta-analysis. Meta-analysis showed that patients in the PDT trial group had reduced peri-implant probing depth (PD) during the follow-up period compared with the control group [WMD=-0.40, 95%CI(-0.62,-0.17), P = .0005], and bleeding on probing (BOP) was reduced [WMD=-9.20, 95%CI(-13.69,-4.71), P < .0001] more significantly, and the difference between the two groups was statistically significant (P < .05); while for Modified plaque index (mPI) decreased [MD=-0.07, 95%CI (-0.16, 0.01), P = .09], clinical attachment loss (CAL) gained [WMD=-0.66, 95%CI:(-1.46, 0.14), P = .11]. Plaque index (PI%) decreased [WMD=-1.66, 95%CI:(-3.43, 0.11), P = .07] insignificantly, and the difference between the two groups was not statistically significant (P > .05).Photodynamic Therapy (PDT) has been significantly effective in reducing periodontal pocket depth and gingival bleeding in the treatment of periodontal diseases. However, its efficacy in improving plaque control and promoting tooth attachment is limited, which may be attributed to its primary antibacterial action rather than promoting tissue repair.

CONCLUSION: Compared to other non-surgical treatments, PDT treatment has significant advantages in reducing peri-implant probing depth and bleeding in patients with peri-implantitis. These results suggest that PDT may be a more effective non-surgical option for reducing probing depth and bleeding in patients with peri-implantitis. Of course, future studies with larger sample sizes and longer follow-up periods are needed to confirm these findings.

PMID:38687855

Altern Ther Health Med. 2024 Apr 26:AT9031. Online ahead of print.

ABSTRACT

OBJECTIVE: Deep venous thrombosis (DVT) refers to a clot in a deep vein caused by various reasons. If such a clot becomes dislodged, it can return to the vein and lead to pulmonary embolism (PE), which can cause death in severe cases. Therefore, we aimed to evaluate the efficacy and safety of Safflower yellow combined with low molecular weight heparin (LMWH) for the prevention of DVT after orthopedic surgery.

METHODS: A comprehensive search of randomized controlled studies (RCTs) of Safflower yellow combined with LMWH for the prevention of DVT after orthopedic surgery was performed in PubMed, Embase, Cochrane Library, CNKI, VIP, and Wanfang databases from January 2000 to June 2021. Data were extracted for quality evaluation and meta-analysis was performed using RevMan 5.3 software.

RESULTS: A total of 8 RCTs including 624 patients were included. The combination treatment reduced the incidence of DVT compared with the control group; the combination treatment improved the activated partial thromboplastin time (APTT) and prothrombin time (PT). There was no statistically significant difference in the incidence of adverse effects.

CONCLUSION: Safflower yellow combined with LMWH can reduce postoperative blood hypercoagulability and prevent DVT formation in lower extremities in orthopedic patients, and achieves better outcomes than LMWH alone in terms of postoperative bleeding tendency.

PMID:38687854

Altern Ther Health Med. 2024 Apr 26:AT10368. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to elucidate the significance of HOX11 gene expression in acute leukemia, offering insights for readers unfamiliar with this gene’s role.

METHODS: We utilized qRT-PCR to examine HOX11 expression in 76 patients, categorizing them into high and low expression groups based on specific thresholds established for this study. Real-time quantitative polymerase chain reaction (qRT-PCR) was performed at the time of diagnosis and on day 28, associated with the analysis of the correlation of HOX11 gene expression with clinical outcomes and prognosis.

RESULTS: On days 0 and 28, the median HOX11 gene expression in patients with acute myeloid leukemia (AML) was 16.2 and 4.43, respectively, which was 9.67 and 2.37 in patients with acute lymphocytic leukemia (ALL), respectively. Enrolled patients were further divided into high genome and low expression groups based on the expression of HOX11. The median HOX11 gene expression on days 0 and 28 in nonresponders to therapy was significantly higher than that in responders to therapy. In addition, baseline HOX11 gene expression was significantly lower in patients with complete remission than in patients with recurrence. The high expression of the HOX11 gene was associated with shorter overall survival time and disease-free survival time. Our findings reveal significant differences in HOX11 expression between patient groups and across time points, suggesting implications for patient prognosis. The results consistently highlight statistically significant differences, enhancing the study’s validity.

CONCLUSION: The study suggests the potential of using HOX11 expression as a marker in clinical practice for monitoring acute leukemia prognosis.

PMID:38687853

Altern Ther Health Med. 2024 Apr 26:AT10042. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to evaluate the impact of OLIF on spinal-pelvic sagittal parameters and its correlation with clinical outcomes in patients with degenerative lumbar spondylolisthesis.

METHODS: A retrospective analysis of 43 patients (23 males, 20 females) with lumbar 4/5 degenerative spondylolisthesis who underwent OLIF from January 2018 to January 2023 was conducted. Key parameters studied included SP, DH, FH, AS, LL, SS, PT, PI, and LASD.

RESULTS: All surgeries were successfully completed according to the original plan, and the minimum follow-up time was greater than 6 months, with a mean operation time of 198.21±51.32 min; the mean intraoperative bleeding volume was 121.00±56.88 ml. The VAS score of lumbar pain and ODI index decreased from the preoperative VAS score, and the ODI index of lower lumbar pain from the preoperative VAS score of 6.50±1.36 and 74.36±6.27 to the postoperative Lumbar pain of 3.20±1.28 and 32.41±8.21, respectively, and the differences were statistically significant (P < .05). 6.27 to 3.20±1.28 and 32.41±8.21 at the final follow-up visit. The differences were statistically significant (P < .05). The results of Pearson correlation analysis showed positive correlation between postoperative LL and FH, SP and AS, VAS (P < .05), and service correlation between SP and SS, LASD (P < .05), and correlation between pre- and post-surgery difference of LL, FH, SP and the improvement rate of ODI and VAS scores (P < .05), with the difference of pre- and post-surgery difference of LL, FH and the ODI, VAS score improvement rate were the strongest correlation. Postoperatively, significant improvements were observed in LL and FH. Pearson correlation analysis indicated a positive correlation between changes in sagittal parameters and clinical outcomes, measured by VAS and ODI scores.

CONCLUSION: The postoperative spine-pelvis sagittal parameters were significantly improved compared with the preoperative ones, and the changes of the spine-pelvis sagittal parameters before and after the operation were correlated with the clinical outcomes, among which the differences of LL and FH had the strongest correlation with the improvement rates of ODI and VAS scores. OLIF effectively improved spinal-pelvic sagittal parameters and clinical outcomes in degenerative lumbar spondylolisthesis, with changes in LL and FH showing the strongest correlation with patient-reported outcome improvements. An oblique lateral interbody fusion can effectively reconstruct spine-pelvis sagittal parameters in patients with degenerative lumbar spondylolisthesis.

PMID:38687852

Altern Ther Health Med. 2024 Apr 26:AT10040. Online ahead of print.

ABSTRACT

OBJECTIVE: Iatrogenic skin injury is a common neonatal skin problem that can have a severe impact on the health and life of newborns. The purpose of this study was to explore the factors influencing iatrogenic skin injury in neonates, identify and correct nursing behaviors that may lead to skin damage, thereby reduce the occurrence of skin damage and protect the health of newborns.

METHODS: The clinical data of 87 neonates with iatrogenic skin injury admitted to the Department of Neonatology of Shangrao People’s Hospital, China, between January and June 2022, were retrospectively collected as a research group. The causes of iatrogenic skin injury were statistically analyzed. 50 neonates without iatrogenic skin injury in the same department during the same period were selected as the control group. The general data of the two groups were contracted, and the independent risk factors affecting iatrogenic skin injury in neonates were explored using multivariate Logistic regression. The corresponding nursing strategies were analyzed.

RESULT: (1) Among the 87 neonates with iatrogenic skin injury, the causes included adhesive dressing stripping (41.38%, 36/87), skin scratch during blue light phototherapy (25.29%, 22/87), diaper dermatitis (20.69%, 18/87), and skin pressure redness related to ventilator and continuous positive airway pressure (CPAP) (12.64%, 11/87). (2) The gestational age, birth weight, length of stay, use of noninvasive mechanical ventilation, orotracheal intubation, gastric tube, PICC catheterization, and skin allergy history of the two groups had statistically significant differences (P < .05). (3) The results of multivariate Logistic regression analysis indicated that the length of stay (OR=2.994, 95% CI=1.341~6.686), orotracheal intubation use (OR=0.015, 95% CI=0.004~0.060), and gastric tube use (OR=17.132, 95% CI=5.231~56.108) were independent risk factors of iatrogenic skin injury in neonates (P < .05).

CONCLUSION: Length of stay, orotracheal intubation use, and gastric tube use are independent risk factors for iatrogenic skin injury in neonates. Hospital stays and unnecessary use of orotracheal intubation and gastric tube should be reduced in future clinical management. Attention should be paid to strengthening skin observation and care, keeping skin dry and clean, and preventing iatrogenic skin injury.

PMID:38687850

MMWR Surveill Summ. 2024 May 2;73(2):1-11. doi: 10.15585/mmwr.ss7302a1.

ABSTRACT

PROBLEM/CONDITION: A 2019 report quantified the higher percentage of potentially excess (preventable) deaths in U.S. nonmetropolitan areas compared with metropolitan areas during 2010-2017. In that report, CDC compared national, regional, and state estimates of preventable premature deaths from the five leading causes of death in nonmetropolitan and metropolitan counties during 2010-2017. This report provides estimates of preventable premature deaths for additional years (2010-2022).

PERIOD COVERED: 2010-2022.

DESCRIPTION OF SYSTEM: Mortality data for U.S. residents from the National Vital Statistics System were used to calculate preventable premature deaths from the five leading causes of death among persons aged <80 years. CDC’s National Center for Health Statistics urban-rural classification scheme for counties was used to categorize the deaths according to the urban-rural county classification level of the decedent’s county of residence (1: large central metropolitan [most urban], 2: large fringe metropolitan, 3: medium metropolitan, 4: small metropolitan, 5: micropolitan, and 6: noncore [most rural]). Preventable premature deaths were defined as deaths among persons aged <80 years that exceeded the number expected if the death rates for each cause in all states were equivalent to those in the benchmark states (i.e., the three states with the lowest rates). Preventable premature deaths were calculated separately for the six urban-rural county categories nationally, the 10 U.S. Department of Health and Human Services public health regions, and the 50 states and the District of Columbia.

RESULTS: During 2010-2022, the percentage of preventable premature deaths among persons aged <80 years in the United States increased for unintentional injury (e.g., unintentional poisoning including drug overdose, unintentional motor vehicle traffic crash, unintentional drowning, and unintentional fall) and stroke, decreased for cancer and chronic lower respiratory disease (CLRD), and remained stable for heart disease. The percentages of preventable premature deaths from the five leading causes of death were higher in rural counties in all years during 2010-2022. When assessed by the six urban-rural county classifications, percentages of preventable premature deaths in the most rural counties (noncore) were consistently higher than in the most urban counties (large central metropolitan and fringe metropolitan) for the five leading causes of death during the study period.During 2010-2022, preventable premature deaths from heart disease increased most in noncore (+9.5%) and micropolitan counties (+9.1%) and decreased most in large central metropolitan counties (-10.2%). Preventable premature deaths from cancer decreased in all county categories, with the largest decreases in large central metropolitan and large fringe metropolitan counties (-100.0%; benchmark achieved in both county categories in 2019). In all county categories, preventable premature deaths from unintentional injury increased, with the largest increases occurring in large central metropolitan (+147.5%) and large fringe metropolitan (+97.5%) counties. Preventable premature deaths from CLRD decreased most in large central metropolitan counties where the benchmark was achieved in 2019 and increased slightly in noncore counties (+0.8%). In all county categories, preventable premature deaths from stroke decreased from 2010 to 2013, remained constant from 2013 to 2019, and then increased in 2020 at the start of the COVID-19 pandemic. Percentages of preventable premature deaths varied across states by urban-rural county classification during 2010-2022.

INTERPRETATION: During 2010-2022, nonmetropolitan counties had higher percentages of preventable premature deaths from the five leading causes of death than did metropolitan counties nationwide, across public health regions, and in most states. The gap between the most rural and most urban counties for preventable premature deaths increased during 2010-2022 for four causes of death (cancer, heart disease, CLRD, and stroke) and decreased for unintentional injury. Urban and suburban counties (large central metropolitan, large fringe metropolitan, medium metropolitan, and small metropolitan) experienced increases in preventable premature deaths from unintentional injury during 2010-2022, leading to a narrower gap between the already high (approximately 69% in 2022) percentage of preventable premature deaths in noncore and micropolitan counties. Sharp increases in preventable premature deaths from unintentional injury, heart disease, and stroke were observed in 2020, whereas preventable premature deaths from CLRD and cancer continued to decline. CLRD deaths decreased during 2017-2020 but increased in 2022. An increase in the percentage of preventable premature deaths for multiple leading causes of death was observed in 2020 and was likely associated with COVID-19-related conditions that contributed to increased mortality from heart disease and stroke.

PUBLIC HEALTH ACTION: Routine tracking of preventable premature deaths based on urban-rural county classification might enable public health departments to identify and monitor geographic disparities in health outcomes. These disparities might be related to different levels of access to health care, social determinants of health, and other risk factors. Identifying areas with a high prevalence of potentially preventable mortality might be informative for interventions.

PMID:38687830 | DOI:10.15585/mmwr.ss7302a1