Identifying and exploring physical and psychological morbidity and patient and family caregiver resilience following acute wound development and/or wound blistering post orthopaedic surgery: a systematic review

The aim of this article was to identify the literature that examined and explored physical and psychological morbidity and patient and family caregiver resilience following acute wound development and/or wound blistering post orthopaedic surgery. A systematic review of the literature using the databases MEDLINE, CINAHL and EMBASE was undertaken. The papers were examined using title and abstract for relevance to the primary and secondary outcomes. The primary outcome of interest was family caregiver resilience following acute wound development and/or wound blistering post orthopaedic surgery. The search yielded 275 records after removing any duplicates; eight studies were considered eligible and were reviewed as full text. Following full review, none of the studies was included in this article. To conclude, there were no papers that investigated or examined the concept of resilience in relation to the management of acute post‐surgical orthopaedic wounds. Four of the papers identified, following the review process, did discuss quality of life outcomes and how these may be improved following wound development; most papers focused on the management of chronic wounds. It is apparent from the review that there is no evidence currently available that explores patient and family caregiver resilience following acute wound development and/or wound blistering post orthopaedic surgery.     

个体特征与尿失禁相关性皮炎多中心发病率关系研究

目的：探讨个体特征与尿失禁相关性皮炎多中心发病率之间的关系。方法回顾性分析惠州市第一人民医院和惠州市第三人民医院普通病房、重症监护病房138例尿失禁患者的临床病历资料,采用单因素和Logistic回归多因素分析个体特征不同与尿失禁相关性皮炎之间的相关性。结果尿失禁相关性皮炎发生率为36.23％（50／138）。单因素分析显示,性别、是否合并高血压、是否合并糖尿病、身体质量指数、白蛋白水平、有无机械通气、有无服用镇静药、体温、抗菌药应用种数、Braden评分和尿失禁次数等个体特征是尿失禁相关性皮炎的影响因素,其发病率差异具有统计学意义（ P＜0.05）。 Logistic回归多因素分析显示, Braden评分、抗菌药应用种数和合并糖尿病是尿失禁相关性皮炎发病率的独立危险因素。结论尿失禁患者自身个体特征与其并发相关性皮炎明显相关,通过科学应用Braden量表,制定合理抗菌药物治疗方案及控制血糖水平,有助于降低尿失禁相关性皮炎的发生风险。     

云南省钩端螺旋体病地理分布规律

根据多年来获得的钩端螺旋体病人群发病率、感染率及宿主动物带菌率等调查资料,结合有关地理气候文献对地理层次及气候的划分指标,将云南省钩端螺旋体病的地理立体分布划为三层来认识,发现其分布流行规律是:低热层为重度流行层,发病率高达229~626/10万,感染率26~30%;中暖层发病率在100/10万左右,感染率12~14%,为中度流行层;高寒层为轻度流行层,发病率﹤0/10万,感染率0.8~6.0%。海拔高度与发病率、感染率分布呈反比关系;海拔高度与发病率作相关回归分析,结果显示密切的直线负相关(r=-0.964),以感染率为指标作相关回归分析,呈高度的曲线负相关(r=-0.987),进一步阐明了钩体病的地理立体分布流行规律,为防治提供科学依据。     

Positive health outcomes following health-promoting and disease-preventive interventions for independent very old persons: Long-term results of the three-armed RCT Elderly Persons in the Risk Zone

The aim of this study was to analyze the long-term effect of the two health-promoting and disease-preventive interventions, preventive home visits and senior meetings, with respect to morbidity, symptoms, self-rated health and satisfaction with health. The study was a three-armed randomized, single-blind, and controlled trial, with follow-ups at one and two years after interventions. A total of 459 persons aged 80 years or older and still living at home were included in the study. Participants were independent in ADL and without overt cognitive impairment. An intention-to-treat analysis was performed. The result shows that both interventions delayed a progression in morbidity, i.e. an increase in CIRS-G score (OR = 0.44 for the PHV and OR = 0.61 for senior meetings at one year and OR = 0.60 for the PHV and OR = 0.52 for the senior meetings at two years) and maintained satisfaction with health (OR = 0.49 for PHV and OR = 0.57 for senior meetings at one year and OR = 0.43 for the PHV and OR = 0.28 for senior meetings after two years) for up to two years. The intervention senior meetings prevented a decline in self-rated health for up to one year (OR = 0.55). However, no significant differences were seen in postponing progression of symptoms in any of the interventions. This study shows that it is possible to postpone a decline in health outcomes measured as morbidity, self-rated health and satisfaction with health in very old persons at risk of frailty. Success factors might be the multi-dimensional and the multi-professional approach in both interventions. Trial registration: NCT0087705.     

Relation Between Quality of Life and Morbidity and Mortality in COPD Patients: Two-Year Follow-Up Study

ABSTRACT

Quality of life (QoL) is being recognized as an important outcome when evaluating chronic obstructive pulmonary disease (COPD) patients. This study aims at identifying the relation between QoL parameters and mortality and morbidity in COPD patients by using the St. George Respiratory Questionnaire (SGRQ). In this prospective study, 251 COPD patients as defined by American Thoracic Society (ATS) criteria were included. A total of 218 patients (86.85%) were male and mean age was 65.55 years. A pulmonary function test (PFT) and SGRQ were performed at the beginning, first, and second years. During a two-year follow-up, the first exacerbation day, the number of exacerbations and intubations, the number and duration of hospitalizations, hospitalizations in an intensive care unit, and exitus day were recorded. When the correlation between FEV₁, SGRQ scores, and these parameters was investigated, there was significant correlation between these parameters, and this correlation was more significant in SGRQ scores than FEV₁ (Pearson correlation test). The activity score of SGRQ was found to be more useful than other scores (Cox regression analysis). Not only PFT but also QoL questionnaires are useful in determining the prognosis of COPD. QoL questionnaires provide a valid and standardized estimate of the overall impact of COPD, and can complement spirometric measurements of baseline assessment of patients in routine practice.     

Papel de la antitrombina iii en cirugía cardiaca

Coagulation of blood is of multidisciplinary interest. Cardiac surgery produces major changes in the delicate balance between pro-and anti-coagulant serum factors. The role of antithrombin iii has been analysed after finding evidence that associated decreased levels of protein activity to postoperative morbidity and mortality. Supplementing exogenous antithrombin is considered with the aim of optimising outcomes. Its intrinsic anticoagulant and anti-inflammatory properties have stimulated a growing interest, and suggests new lines of research.