ON WHICH DAY IS PAIN WORST FOLLOWING ADULT TONSILLECTOMY?

SUMMARY Anecdotal evidence from several ENT departments suggests that pain following tonsillectomy is worst on the second and/or third days after surgery. This study tests this hypothesis. A pilot study with 19 subjects suggested this theory might well be true. A fuller study was then carried out on 91 subjects with standardised surgical and anaesthetic techniques, and standardised analgesia for five days postoperatively. Pain on the second and third postoperative days was compared with that eight hours after the operation and on the first, fourth and fifth postoperative days. No statistically significant difference was found. There is increasing pressure for early discharge from hospital after surgery. If pain following tonsillectomy is not going to become worse at home, this will tend to make early discharge more acceptable to patients.     

A comparison of frequency and sources of nursing job stress perceived by intensive care, hospice and medical-surgical nurses

This study compared the frequency and sources of nursing job stress perceived by 35 intensive care (ICU), 30 hospice and 73 medical-surgical nurses. Analysis of variance revealed no significant differences among the three groups of nurses on the overall frequency of job stress. Post-hoc Tukey tests demonstrated a significant difference in three stress subscales among the three groups. ICU and hospice nurses perceived significantly more stress than medical-surgical nurses related to death and dying; ICU and medical-surgical nurses perceived significantly more stress than hospice nurses related to floating; and medical-surgical nurses perceived significantly more stress than ICU and hospice nurses related to work-overload/staffing. Spearman-Rank Correlation revealed no significant correlations among the three groups in their rank-ordering of the eight stress subscales. Death and dying situations were the most stressful to ICU and hospice nurses, while work-overload/staffing situations were the most stressful to medical-surgical nurses. Results of the study, although not generalizable, have implications for nurse managers.     

Increased risk of a positive test for antibody to hepatitis B core antigen (anti-HBC) in autologous blood donors

Controversy exists about the suitability of blood from autologous donors for homologous use. We compared the infectious disease test results of 426 autologous donors, designated by donor history as suitable for homologous use, to those of 86,138 volunteer donations collected over the same 5 month period. Although donor characteristics differed, the relative risk of a positive test for anti-HBc in the autologous group was 2.09. When 413 autologous donors were compared to 413 volunteer donors matched for age, sex, and zip code, the relative risk of a positive test for anti-HBc in the autologous group was 3.2. If anti-HBc is a marker for non-A, non-B hepatitis transmissibility, then our autologous group is not as safe as our volunteer donors. We recommend that autologous blood, even when designated by donor history and laboratory screening results as suitable for homologous transfusion, not be used for other than the intended autologous recipient.     

DRUGS AFFECTING THE LEUKOTRIENE PATHWAY IN ASTHMA

SUMMARY Drugs affecting the leukotriene pathway are emerging as a new class of asthma treatment — the first for more than 20 years. Development of these leukotriene antagonists should lead to greater understanding of the underlying processes in asthma and may result in a safe, oral, anti-asthmatic drug to benefit particular groups of asthmatic patients.     

Prognostic and Predictive Significance of Eukaryotic Elongation Factor 1D (eEF1D) in Breast Cancer: A Potential Marker of Response to Endocrine Therapy

Components of the protein synthesis machinery are subjected to alterations in cancer cells. eEF1D gene, which lies within the frequently amplified 8q24 locus, is one of the subunits of the human eukaryotic elongation factor complex. This study aimed to evaluate the prognostic and predictive significance of eEF1D in breast cancer using in silico analysis tools. For this purpose, we analyzed genomic alterations of the eEF1D gene using TCGA datasets via cBioPortal. Histopathological analysis was performed on patient tissue images obtained from cBioPortal and the Human Protein Atlas. Survival analysis was carried out using the KM Plotter and the prediction of response to therapy was assessed via the ROC Plotter. We found that eEF1D was highly amplified and overexpressed in breast invasive carcinoma. Increased expression of eEF1D was correlated with increased structural disorganization and morphological alterations at the cellular level, as well as a shorter period of overall survival. Furthermore, prediction of response to therapy showed that patients with eEF1D overexpression responded significantly better to endocrine therapy. In conclusion, our results suggest a cancer-promoting role for eEF1D, associated with poor prognosis and points towards its predictive value in providing better tailored treatment options for a patient.     

Demonstrating an approach for evaluating synthetic geospatial and temporal epidemiologic data utility: results from analyzing >1.8 million SARS-CoV-2 tests in the United States National COVID Cohort Collaborative (N3C)

ObjectiveThis study sought to evaluate whether synthetic data derived from a national coronavirus disease 2019 (COVID-19) dataset could be used for geospatial and temporal epidemic analyses.Materials and MethodsUsing an original dataset (n = 1 854 968 severe acute respiratory syndrome coronavirus 2 tests) and its synthetic derivative, we compared key indicators of COVID-19 community spread through analysis of aggregate and zip code-level epidemic curves, patient characteristics and outcomes, distribution of tests by zip code, and indicator counts stratified by month and zip code. Similarity between the data was statistically and qualitatively evaluated.ResultsIn general, synthetic data closely matched original data for epidemic curves, patient characteristics, and outcomes. Synthetic data suppressed labels of zip codes with few total tests (mean = 2.9 ± 2.4; max = 16 tests; 66% reduction of unique zip codes). Epidemic curves and monthly indicator counts were similar between synthetic and original data in a random sample of the most tested (top 1%; n = 171) and for all unsuppressed zip codes (n = 5819), respectively. In small sample sizes, synthetic data utility was notably decreased.DiscussionAnalyses on the population-level and of densely tested zip codes (which contained most of the data) were similar between original and synthetically derived datasets. Analyses of sparsely tested populations were less similar and had more data suppression.ConclusionIn general, synthetic data were successfully used to analyze geospatial and temporal trends. Analyses using small sample sizes or populations were limited, in part due to purposeful data label suppression—an attribute disclosure countermeasure. Users should consider data fitness for use in these cases.     

阴性精神分裂症患者局部脑血流测定与威斯康星卡片分类测验的相关分析

阴性精神分裂症患者局部脑血流测定与威斯康星卡片分类测验的相关分析吴永刚刘哲宁苏见知刘泽云李炎升罗建民解亚宁赵靖平杨玲玲附表１２例阴性型精神分裂症患者静息与负荷时ｒＣＢＦ（ｘ±ｓ）变化部位安静状态下Ｒｆ／Ｗｆ负荷状态下Ｒｓ／ＷｓＢＦＣＲ左侧大脑右侧大脑...