Outcomes of cardiopulmonary resuscitation in dialysis patients.

Patients with renal failure are believed to have a poor survival rate after cardiopulmonary resuscitation, but there is little specific information about the outcomes of cardiopulmonary resuscitation in dialysis patients. To be better able to inform dialysis patients and assist them in decision making about cardiopulmonary resuscitation, the eight-year experience with cardiopulmonary resuscitation in dialysis patients at a university dialysis program was analyzed and outcomes were compared with those of a control group of nondialysis patients undergoing cardiopulmonary resuscitation during the same time period in the same hospital. Of 221 dialysis patients experiencing cardiopulmonary arrest, 74 (34%) had CPR compared with 247 (21%) of 1,201 control patients (P = 0.0002). Six of 74 (8%; 95% confidence interval, 2 to 14%) dialysis patients survived to hospital discharge compared with 30 of 247 (12%; 95% confidence interval, 8 to 16%) control patients (P = not significant). At 6 months after CPR, 2 (3%) of 74 dialysis patients were still alive compared with 23 (9%) of 247 controls (P = 0.044); this difference was not explained by age or comorbid conditions. Twenty-one (78%) of the 27 successfully resuscitated dialysis patients died a mean of 4.4 days later; 95% were on mechanical ventilation in an intensive care unit at the time of death. It was concluded that cardiopulmonary resuscitation is a procedure that rarely results in extended survival for dialysis patients. In discussions about cardiopulmonary resuscitation with dialysis patients, nephrologists should provide this information.

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The effect of simulation-based education on nursing students’ knowledge and performance of adult basic cardiopulmonary resuscitation: A randomized clinical trial

Nursing Practice Today ◽

10.18502/npt.v7i2.2730 ◽

2020 ◽

Author(s):

Tahereh Habibli ◽

Tahereh Najafi Ghezeljeh ◽

Shima Haghani

Keyword(s):

Nursing Students ◽

Cardiopulmonary Resuscitation ◽

Life Support ◽

Cardiopulmonary Arrest ◽

Intervention Group ◽

Control Group ◽

Random Allocation ◽

Simulation Based ◽

And Performance ◽

And Control

Background & Aim: Cardiopulmonary arrest as a life-threatening condition needs urgent interventions to protect individuals’ life and prevent irreversible damages to vital organs. This study aimed to investigate the effect of simulation-based education on the knowledge and performance of nursing students of adult essential life support cardiopulmonary resuscitation (BLS-CPR). Methods & Materials: This study used a pretest-posttest study with a control group. It was conducted at Iran University of medical sciences, Tehran, Iran, in 2017. In this study, 49 nursing students at the sixth education semester were assigned using the simple random allocation into two groups of intervention (n=28) and control (n=21). Initially, the conventional BLS education was provided to the two groups of intervention and control using the conventional method. Next, the intervention group received a simulation-based education. The knowledge and performance of the students before, immediately after, and three months after the intervention was assessed using a modified knowledge assessment questionnaire and a modified performance evaluation checklist about BLS in adults. Results: The students’ knowledge in the intervention group immediately after (p<0.001) and three months after the intervention (p<0.05) were significantly higher than the control group. The mean scores of performance immediately after (p<0.001) and three months after the intervention (p<0.001) were significantly higher than the control group. Conclusions: Simulation-based education increased the knowledge and performance of nursing students in the field of BLS-CPR. According to the results, integrating conventional training with simulation-based education can be effective in learning BLS among nursing students.

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Discussion on the Effect of Emergency Tracheal Intubation on Cardiopulmonary Resuscitation by Emergency Medical Staff

Advanced Emergency Medicine ◽

10.18686/aem.v9i2.169 ◽

2020 ◽

Vol 9 (2) ◽

pp. 49

Author(s):

Xuedong Sun ◽

Chunxiao Dong ◽

Hui He

Keyword(s):

Cardiopulmonary Resuscitation ◽

Tracheal Intubation ◽

Medical Staff ◽

Cardiopulmonary Arrest ◽

Success Probability ◽

Operation Time ◽

Control Group ◽

Emergency Medical ◽

Significant Difference ◽

Experimental Group

<p>Objective: To study the positive effect of emergency tracheal intubation on cardiopulmonary resuscitation. Methods: 90 patients with cardiopulmonary arrest were randomly selected from the emergency department of our hospital from November 2017 to November 2019, and were randomly divided into the control group and the experimental group (n=45). The control group was given routine anesthesia combined with cardiopulmonary resuscitation, while the experimental group was given emergency tracheal intubation combined with cardiopulmonary resuscitation. The effect of cardiopulmonary resuscitation and operation time of the two groups were observed and discussed, and the results were recorded. Results: Under different intervention measures, the time from visiting a doctor to tracheal intubation in the experimental group was obviously shorter than that in the control group (P < 0.05). There is no significant difference in the time of intubation between the two groups (P > 0.05). In addition, the success probability of cardiopulmonary resuscitation and the discharge survival rate in the experimental group were higher than those in the control group (P < 0.05). The above-mentioned results with p < 0.05 indicated the statistically significant differences. Conclusion: In clinical practice, emergency tracheal intubation for patients with cardiopulmonary arrest by emergency medical staff can bring a higher success probability of cardiopulmonary resuscitation, buy valuable time for rescue operation, and obviously improve the prognosis of patients. Therefore, it is worthy of wider promotion and application.</p>

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Turbinate Submucosal Reduction Operation Reduced Migraine Admission among Patients with Chronic Hypertrophic Rhinitis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17155455 ◽

2020 ◽

Vol 17 (15) ◽

pp. 5455

Author(s):

Chun-An Cheng ◽

Yin-Han Chang ◽

Chun-Gu Cheng ◽

Hung-Che Lin ◽

Chi-Hsiang Chung ◽

...

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Control Group ◽

Proportional Hazard ◽

Comorbid Conditions ◽

Reduction Operation ◽

Cox Proportional Hazard ◽

Chronic Hypertrophic Rhinitis ◽

Cox Proportional Hazard Regression ◽

The Relationship

Rhinitis increases migraine risk. Chronic hypertrophic rhinitis can be treated with turbinate submucosal reduction operation. The relationship between migraine and chronic hypertrophic rhinitis after turbinate submucosal reduction operation is still unclear. The goal of this study was to evaluate the correlation between turbinate submucosal reduction operation and subsequent migraine admission in Asian chronic hypertrophic rhinitis patients. We identified patients suffering from chronic hypertrophic rhinitis and receiving turbinate submucosal reduction operation. The control group was selected from patients with chronic hypertrophic rhinitis without operation. The event was migraine admission. The risk factors of migraine admission were established using multivariate Cox proportional hazard regression. The risk of migraine admission after turbinate submucosal reduction operation is represented by a hazard ratio (HR) of 0.858 (95% confidence interval (CI): 0.633–0.962). The higher risk of migraine included depression with HR 4.348 (95% CI: 2.826–6.69), anxiety with HR 3.75 (95% CI: 2.267–6.203), fibromyalgia with HR of 7.326 (95% CI: 3.427–15.661), and asthma with HR 1.969 (95% CI: 1.11–3.491). Our study revealed that turbinate submucosal reduction operation led to a 14.2% reduction in migraine admission. Clinicians should understand the benefit of turbinate submucosal reduction operation and provide suitable treatments for comorbid conditions. Further prospective studies are required to confirm our findings.

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Impact of an educative program on dialysis patients’ knowledge and mental health: controlled before and after program

Education thérapeutique du patient - Therapeutic patient education ◽

10.1051/tpe/2018015 ◽

2018 ◽

Vol 10 (2) ◽

pp. 20204

Author(s):

Laetitia Idier ◽

Aurélie Untas ◽

Nicole Rascle ◽

Michèle Koleck ◽

Maider Aguirrezabal ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Vascular Access ◽

Educational Program ◽

Psychological State ◽

Control Group ◽

Dialysis Patients ◽

Emotional Change ◽

The Impact ◽

Experimental Group

Introduction:Psychological impact of Therapeutic Patient Education (TPE) for dialysis patients is rarely evaluated since the focus of many studies is on medical variables (i.e., adherence).Objectives:The aims of this study were: 1) to estimate the impact of a TPE program on knowledge, depression and anxiety, 2) to examine change in knowledge as a mediator of the effects of a TPE program on mental health.Method:This study was conducted in three hemodialysis units and comprised two groups: an experimental group with education and a control group with routine care. The program was based of 5 educative sessions. Knowledge, depressive and anxious symptoms were assessed with self-reported outcomes measured before and 3 months after the program.Results:The sample comprised 125 patients. Knowledge about vascular access and nutrition (p < 0.01) and depressive symptoms increased in the experimental group (p < 0.01). Analysis of mediation showed that changes in knowledge about vascular access were a significant mediator of the effects of the program on depressive symptoms (F = 4.90;p = 0.01).Discussion:Knowledge acquired during an educational program could lead to an emotional change. Improving knowledge often leads to an awareness of the risks that can modify the psychological state of patients by reminding them of their vulnerability. This study shows that it is required to be attentive to the way of transmitting knowledge. It’s necessary adapting this transmission to the needs of patients and promoting the acquisition of psychosocial competence too.Conclusion:This study shows that knowledge acquired during an educational program can lead to an emotional change in the short term. A long-term follow-up of the population should be interesting to observe these emotional effects.

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Retinal vascular fractal dimensions and their association with macrovascular cardiac disease.

Ophthalmic Research ◽

10.1159/000514442 ◽

2021 ◽

Author(s):

Sebastian Dinesen ◽

Pia Søndergaard Jensen ◽

Maria Bloksgaard ◽

Søren Leer Blindbæk ◽

Jo G.R. De Mey ◽

...

Keyword(s):

Confidence Interval ◽

Cardiac Disease ◽

Artery Bypass ◽

Fractal Dimensions ◽

Macrovascular Disease ◽

Control Group ◽

Vascular Structure ◽

Non Invasive ◽

Automatic Software ◽

Multivariable Regression

Introduction As the only part of the human vasculature, retina is available for direct, non-invasive inspection. Retinal vascular fractal dimension (DF) is a method to measure the structure of the retinal vascular tree, with higher non-integer values between 1 and 2 representing a more complex and dense retinal vasculature. Retinal vascular structure has been associated with a variety of systemic diseases and this study examined the association of DF and macrovascular cardiac disease in a case-control design. Methods Retinal fundus photos were captured with Topcon TRC-50X in 38 persons that had coronary artery bypass grafting (CABG, cases) and 37 cardiovascular healthy controls. The semi-automatic software VAMPIRE was used to measure retinal DF. Results Patients with CABG had lower DF of the retinal main venular vessels compared to the control group (1.15 vs. 1.18, p=0.01). In a multivariable regression model adjusted for gender and age, eyes in the fourth quartile with higher DF were less likely to have CABG compared to patients in the first (OR, 7.20; 95% confidence interval, 1.63 to 31.86; p=0.009) and second quartile (OR, 8.25; 95% confidence interval, 1.70 to 40.01; p=0.009). Conclusions This study demonstrates that lower complexity of main venular vessels associates with higher risk of having CABG. The research supports the hypothesis that the retinal vascular structure can be used to assess non-ocular macrovascular disease.

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Do Children Who Experience Laryngospasm Have an Increased Risk of Upper Respiratory Tract Infection?

Anesthesiology ◽

10.1097/00000542-199609000-00005 ◽

1996 ◽

Vol 85 (3) ◽

pp. 475-480. ◽

Cited By ~ 107

Author(s):

Mark S. Schreiner ◽

Irene O'Hara ◽

Dorothea A. Markakis ◽

George D. Politis

Keyword(s):

Confidence Interval ◽

Respiratory Infection ◽

Odds Ratio ◽

Signs And Symptoms ◽

Control Group ◽

Upper Respiratory Tract ◽

Upper Respiratory Infection ◽

Airway Surgery ◽

Increased Risk ◽

Upper Respiratory

Background Laryngospasm is the most frequently reported respiratory complication associated with upper respiratory infection and general anesthesia in retrospective studies, but prospective studies have failed to demonstrate any increase in risk. Methods A case-control study was performed to examine whether children with laryngospasm were more likely to have an upper respiratory infection on the day of surgery. The parents of all patients (N = 15,183) who were admitted through the day surgery unit were asked if their child had an active or recent (within 2 weeks of surgery) upper respiratory infection and were questioned about specific signs and symptoms to determine if the child met Tait and Knight's definition of an upper respiratory infection. Control subjects were randomly selected from patients whose surgery had occurred within 1 day of the laryngospasm event. Results Patients who developed laryngospasm (N = 123) were 2.05 times (95% confidence interval 1.21-3.45) more likely to have an active upper respiratory infection as defined by their parents than the 492 patients in the control group (P < or = 0.01). The development of laryngospasm was not related to Tait and Knight's definition for an upper respiratory infection or to recent upper respiratory infection. Children with laryngospasm were more likely to be younger (odds ratio = 0.92, 95% confidence interval 0.87-0.99), to be scheduled for airway surgery (odds ratio = 2.08, 95% confidence interval 1.21-3.59), and to have their anesthesia supervised by a less experienced anesthesiologist (odds ratio = 1.69, 95% confidence interval 1.04-2.7) than children in the control group. Conclusion Laryngospasm was more likely to occur in children with an active upper respiratory infection, children who were younger, children who were undergoing airway surgery, and children whose anesthesia were supervised by less experienced anesthesiologists. Understanding the risk factors and the magnitude of the likely risk should help clinicians make the decision as to whether to anesthetize children with upper respiratory infection.

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Impact of interstitial lung disease on mortality in ANCA-associated vasculitis: A systematic literature review and meta-analysis

Chronic Respiratory Disease ◽

10.1177/1479973121994562 ◽

2021 ◽

Vol 18 ◽

pp. 147997312199456

Author(s):

Peining Zhou ◽

Jing Ma ◽

Guangfa Wang

Keyword(s):

Systematic Review ◽

Interstitial Lung Disease ◽

Confidence Interval ◽

Lung Disease ◽

Mortality Risk ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

Anca Associated Vasculitis ◽

Retrospective Cohort Studies

Several retrospectivee described the association of interstitial lung disease (ILD) and ANCA-associated vasculitis (AAV). However, the relationship between the ILD and mortality in AAV patients have not been established so far. This study aims to estimate the relevance of AAV-associated-ILD (AAV-ILD) and mortality risk by conducting a systematic review and meta-analysis.A comprehensive systematic review was conducted in accordance with the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). PubMed, Embase.com and the Cochrane Library (Wiley) were searched for original observational studies. Summary estimates were derived with a random-effects model and reported as risk ratio (RR), tested for publication bias and heterogeneity. Ten retrospective cohort studies were included, comprising 526 AAV-ILD patients enrolled from 1974 to 2018. Meta-analysis yielded a pooled RR of 2.90 (95% confidence interval 1.77–4.74) for death among those with AAV-ILD compared to control group. UIP pattern was associated with an even poorer prognosis in comparison to non-UIP pattern (RR 4.36, 95% confidence interval 1.14–16.78). Sensitivity analysis suggested that the meta-RR result was not skewed by a single dominant study. ILD might be associated with a higher mortality risk in AAV patients.

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Association of interleukin-17A rs2275913 polymorphism with rheumatoid arthritis susceptibility in Sudanese population

SAGE Open Medicine ◽

10.1177/20503121211020207 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110202

Author(s):

Rgda Mohamed Osman ◽

Mounkaila Noma ◽

Abdallah Elssir Ahmed ◽

Hanadi Abdelbagi ◽

Rihab Ali Omer ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Confidence Interval ◽

Statistical Tests ◽

Demographic Data ◽

Control Group ◽

P Value ◽

Case Group ◽

Molecular Technique ◽

Interleukin 17A ◽

Significant Difference

Objectives: Rheumatoid arthritis is a chronic inflammatory autoimmune disease. This study aimed to determine the association of interleukin-17A-197G/A polymorphism with rheumatoid arthritis in Sudanese patients. Methods: A case–control study was conducted between March and December 2018. Clinical and demographic data of the study participants were collected and analyzed. Polymerase chain reaction restriction fragment length polymorphism molecular technique was done to investigate interleukin-17A-197G/A polymorphisms. All statistical tests were considered statistically significant when p < 0.05. Results: The study population included 266 participants aged between 1 and 85 years, with an average of 40 years, classified into 85 (31.2%) cases (mean age 48.5 ± 11.3 years), and 181 (68.8%) controls (mean age 35.3 ± 15.9 years). The interleukin-17A homozygote AA genotype was more frequent among the control group compared to the case group; 95 (52.5%) and 7 (8.2%), respectively. The homozygote GG and the heterozygote AG genotypes were proportionally not different among the cases and control groups; 13 (54.2%) and 11 (45.8%), and 65 (46.4%) and 75 (53.6%), respectively. According to the distribution of interleukin-17A genotypes, a statistically significant difference was observed among cases with the interleukin-17A AA and AG genotypes, p values 0.001 and 0.004, respectively. For the association interleukin-17A genotypes and family history a negatively significant association was reported (95% confidence interval, –0.219, p value = 0.001). There was also a negatively significant association of interleukin-17A genotypes and anti-cyclic citrullinated peptide (95% confidence interval, −0.141, p value = 0.002). Conclusion: This study is the first study in Sudan established the association between interleukin-17A-197G/A (rs2275913) polymorphisms and susceptibly to rheumatoid arthritis. These findings appeal for further research in Sudan to investigate the exact role of IL-17A in immunopathology and disease severity among Sudanese rheumatoid arthritis

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Oxidative Stress in Non-Dialysis-Dependent Chronic Kidney Disease Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157806 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7806

Author(s):

Patricia Tomás-Simó ◽

Luis D’Marco ◽

María Romero-Parra ◽

Mari Carmen Tormos-Muñoz ◽

Guillermo Sáez ◽

...

Keyword(s):

Oxidative Stress ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Reduced Glutathione ◽

Genetic Material ◽

Future Research ◽

Control Group ◽

Dialysis Patients ◽

Early Stages ◽

Molecular Lines

Background: Cardiovascular complications are the leading cause of morbidity and mortality at any stage of chronic kidney disease (CKD). Moreover, the high rate of cardiovascular mortality observed in these patients is associated with an accelerated atherosclerosis process that likely starts at the early stages of CKD. Thus, traditional and non-traditional or uremic-related factors represent a link between CKD and cardiovascular risk. Among non-conventional risk factors, particular focus has been placed on anaemia, mineral and bone disorders, inflammation, malnutrition and oxidative stress and, in this regard, connections have been reported between oxidative stress and cardiovascular disease in dialysis patients. Methods: We evaluated the oxidation process in different molecular lines (proteins, lipids and genetic material) in 155 non-dialysis patients at different stages of CKD and 45 healthy controls. To assess oxidative stress status, we analyzed oxidized glutathione (GSSG), reduced glutathione (GSH) and the oxidized/reduced glutathione ratio (GSSG/GSH) and other oxidation indicators, including malondialdehyde (MDA) and 8-oxo-2’-deoxyguanosine (8-oxo-dG). Results: An active grade of oxidative stress was found from the early stages of CKD onwards, which affected all of the molecular lines studied. We observed a heightened oxidative state (indicated by a higher level of oxidized molecules together with decreased levels of antioxidant molecules) as kidney function declined. Furthermore, oxidative stress-related alterations were significantly greater in CKD patients than in the control group. Conclusions: CKD patients exhibit significantly higher oxidative stress than healthy individuals, and these alterations intensify as eGFR declines, showing significant differences between CKD stages. Thus, future research is warranted to provide clearer results in this area.

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Risk of recurrence of subdural hematoma after EMMA vs surgical drainage – Systematic review and meta-analysis

Interventional Neuroradiology ◽

10.1177/1591019921990962 ◽

2021 ◽

pp. 159101992199096

Author(s):

Joshua Dian ◽

Janice Linton ◽

Jai JS Shankar

Keyword(s):

Confidence Interval ◽

Subdural Hematoma ◽

Meta Analysis ◽

Chronic Subdural Hematoma ◽

Middle Meningeal Artery ◽

Control Group ◽

Complication Rates ◽

Recurrence Rates ◽

Invasive Approach ◽

Risk Of Recurrence

Objective Chronic subdural hematoma (CSDH) is a common and debilitating neurological condition whose treatments, including burr hole drainage and craniotomy, suffer from high rates of recurrence and complication. Embolization of the middle meningeal artery (EMMA) is a promising minimally invasive approach to manage CSDH in a broad set of patients. Methods To evaluate the efficacy and safety of EMMA, a database search was conducted including the terms “subdural hematoma; embolization; embolized; middle meningeal” was performed and yielded a total of 260 results. Following exclusion based on predefined criteria, a total of four studies were identified and outcomes including recurrence rates and complication rates were extracted for analysis. Results Four studies including intervention and control groups were included with a total of n = 888 patients. The relative risk of CSDH recurrence in the EMMA (3.5%) compared to control group (23.5%) was significantly reduced when EMMA was performed (risk ratio = 0.17; 95% confidence interval (CI) 0.05–0.67). In addition, rates of complication were not significantly different between patients with conventional therapy and those who received EMMA (OR = 0.77; 95 confidence interval (CI) 0.3–1.99). Conclusion Based on limited data, EMMA reduces the risk of recurrence by 20% compared to surgical treatment for CSDH.

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