Self-care experiences of Pakistani patients with COPD and the role of family in self-care: A phenomenological inquiry

Self-care enables patients in improving quality of life and reducing hospital admissions. Research explored the experiences of patients about breathlessness, sleep problems and complication management in chronic obstructive pulmonary disease (COPD). However, the self-care experiences and the role of the family in self-care are underexplored. This study aimed to understand the self-care experiences of patients with COPD and explore the role of the family in self-care. An interpretive phenomenological inquiry was used, and 13 patients were interviewed in 2019 from two hospitals in Pakistan. The inclusion criteria were patients above 30 years of age at any stage of COPD, who received a confirmed diagnosis of COPD and were receiving the treatment, and engaged in self-care at their homes or communities. The interviews lasted for 35–60 min. Ricoeur's interpretation theory was used for data analysis comprising steps explanation, naive understanding and in-depth understanding. Self-care emerged as a complex individual and familial endeavour affected by personal, social and economic factors. Poverty was one of the core determinants of self-care. Patients emphasised the spiritual, cultural and traditional approaches to self-care. Future research is warranted to develop better understanding of spiritual and cultural self-care and how these dimensions of self-care affect patients’ self-care behaviours.     

Comparison of efficacy and safety of intralesional triamcinolone and combination of triamcinolone with 5-fluorouracil in the treatment of keloids and hypertrophic scars: Randomised control trial

The treatment of keloid and hypertrophic scar is challenging with no universally accepted mode for permanent ablation. Conventional therapies yield unpredictable results, significant complications and require elaborate hardware.

Clarivate listed nursing journals in 2020: what they publish and how they measure use of social media

Objectives: To investigate what the most common types of articles that nursing journals purport to publish are and what they actually publish. And to investigate the extent to which academic nursing journals listed by Clarivate track alternative metrics.Methods: Journals included in the nursing Journal Citation Report (JCR) journal category in 2019 described as nursing were identified and considered suitable for inclusion in the analysis. Instructions for authors were reviewed online and mention of each type of article is identified. The tables of contents of each issue of each journal published during 2019 were examined and the types of articles published were extracted to a spreadsheet into permitted article types and published articles. Likewise, the use of alternative metrics by each journal was extracted to a spreadsheet. Pearson's and Spearman's correlation analysis was applied to investigate the relationship between articles permitted and articles published.Results: In the 2020 JCR, 123 journals were listed. The most common article type permitted was original research (n = 117),followed by review papers (n = 116), and discussion papers (n = 63). Original research (n = 7045); review papers (n = 1268);discussion papers (n = 1225); editorials (n = 793) and commentaries (n = 776) were the most commonly published categories of the article. Of journals examined, 108 (96.8％) tracked mentions on social media and the Altmetric score was most commonly used (75％). There was a strong correlation (r = 0.73; P = 0.002) between the numbers of articles permitted and published and a strong correlation (ρ = 0.86; P < 0.001) in terms of the rankings of the permitted and published articles.Conclusions: There is a relationship between the most frequently permitted article types and those published, especially for the most frequent categories of both. Original articles, review papers, and discussion papers are the backbone of academic publishing in nursing with original articles vastly outweighing review and discussion papers. Most Clarivate listed journals now use some method of tracking alternative metrics indicating how seriously publishers take their social media profiles.     

New vascular sheath for subcutaneous drug administration: Design,animal testing,and clinical application for pain prevention after angioplasty

A new vascular sheath design (anesthesia infusion sleeve or AIS) was developed to enable administration of local anesthetics or other medications into the subcutaneous tissue around the insertion site without any additional needle sticks or other manipulation. Design of the system was based upon anatomic measurements of femoral artery depth in 150 patients. Animal studies of prototypes verified subcutaneous delivery using both radiographic methods and direct dissection. The pharmacokinetic profile of plasma lidocaine was also studied in three pigs to document subcutaneous delivery with the AIS. Subsequently a clinical trial of the AIS versus a standard sheath was done in 20 patients undergoing coronary angioplasty. Pain associated with sheath removal was graded using a verbal scale at baseline, during infiltration of the area, and at 1-min intervals during compression for 15 min. Baseline pain was identical in both groups, whereas, during infiltration with lidocaine, pain increased in the standard sheath group and decreased in the AIS group. Pain increased slightly in both groups with initial compression; however, it was significantly less in the AIS group. This difference persisted for several minutes after initial compression. The AIS represents a simple addition to standard sheath protocol offering superior pain control compared to standard technique for sheath removal without the need for systemic analgesics or other medications. © 1996 Wiley-Liss, Inc.     

HMG-CoA reductase inhibitors in kidney transplant recipients receiving tacrolimus: statins not associated with improved patient or graft survival

Background

Previously the angiotensin II receptor blocker Irbesartan has been demonstrated to reduce the risk for progression from microalbuminuria to macroalbuminuria in type 2 diabetic patients. The purpose of this study was to evaluate the effect of treatment with Irbesartan in type 2 diabetic patients with microalbuminuria on the urinary proteome.

Methods

High-resolution capillary-electrophoresis coupled to mass-spectrometry (CE-MS) was used to profile the low-molecular-weight proteome in urine of a subgroup of patients from a two year randomized irbesartan versus placebo therapy trial, which included hypertensive type 2 diabetic patients with microalbuminuria on ongoing antihypertensive medication (IRMA2-substudy).

Results

We demonstrate that the therapy with 300 mg Irbesartan daily over a period of two years results in significant changes of the urinary proteome. Both, a classifier developed previously that consists of urinary peptides indicative of chronic kidney disease, as well as several individual peptides changed significantly after treatment. These changes were not observed in the placebo-treated individuals. Most prominent are changes of urinary collagen fragments associated with progression of diabetic nephropathy, indicating normalization in urinary peptides.

Conclusion

CE-MS analysis of urine enabled identification of peptides as potential surrogate markers for renoprotection in microalbuminuric type 2 diabetic patients, which show persistent improvement after longterm treatment with Irbesartan. The results suggest that a major benefit of treatment by Irbesartan may be improvement of collagen turnover, reduction of fibrosis. They further suggest that urinary proteome analysis could be utilized to assess potential benefit of therapeutic intervention, providing statistically significant results even on a small population.     

An evaluation of the effectiveness of the Opportunities for Resuscitation and Citizen Safety (ORCS) defibrillator training programme designed for older school children

OBJECTIVES: The aim of our study was to evaluate the effect of an automated external defibrillation (AED) training programme on the knowledge, attitudes and application of BLS and AED use in young people of secondary school age in Manchester, United Kingdom. METHOD: Students from two schools who had piloted Opportunities for Resuscitation and Citizen Safety (ORCS) in the academic year 2004/2005 volunteered to partake in the study. This 'ORCS intervention' group was compared against a control group, which consisted of students who had no formal training in resuscitation nor, to our knowledge, any other form of life support training during their time at secondary school. All students were assessed and scored on their knowledge and performance of the BLS algorithm (in accordance with the UK Resuscitation Council ('Resuscitation Guidelines for the Citizen') and the use of a trainer defibrillator on a fictional cardiac arrest scenario. RESULTS: We compared 34 ORCS-trained students with 25 control students, all aged between 13 and 16 years. Approximately, twice as many ORCS-trained students than the control students performed many parts of the algorithm correctly, such as checking for danger, checking for response, opening the airway and checking for breathing. More than three times as many ORCS-trained students than controls correctly performed CPR (50% versus 12% of students). As expected, the use of the AED was the part of the algorithm performed worst, but was performed correctly by six times as many ORCS students as controls (27% versus 4% of students). CONCLUSIONS: This study demonstrates that training through the ORCS scheme has a positive influence on the ability of secondary school teenagers to perform emergency life support (ELS), but particularly in their ability to deploy an AED and perform CPR.     

Detection and identification of mouse mammary tumor virus-like DNA sequences in blood and breast tissues of breast cancer patients

Mouse mammary tumor virus (MMTV) is a well-known cause of mammary tumors in mice transmitted as endogenous proviruses or exogenously as infectious virions. The hypothesis that a retrovirus homologous to MMTV is involved in human breast cancers has resulted in renewed interest in the etiology of human breast cancer. Therefore, the detection of MMTV-like exogenous sequences in 30–40 % of invasive breast cancer has increased attention towards this hypothesis. To detect the prevalence of MMTV in Pakistani population, 666-bp-long MMTV envelop and 630-bp LTR sequences were amplified from breast cancer patient samples (tissue biopsies and peripheral blood) using mouse with mammary tumor as control. MMTV-like virus env and LTR DNA sequences were detected in 20 and 26 % of breast tumor samples, respectively, from the total of 80 breast cancer patients’ blood and tissue samples. No significant association was observed between age, grade of disease, and lymph node involvement with the prevalence of MMTV-like sequences. Our data add to the growing number of studies implicating MMTV-like virus in human breast cancer, but still clear causal association of MMTV to breast cancer remains to be reputable.