scholarly journals Impact of Dexmedetomidine On Secondary Hyperparathyroidism Recurrence In Uremic Patients Who Received Parathyroidectomy With Auto-Transplantation: A Retrospective Propensity-Matched Study

Author(s):  
Yun Wu ◽  
Wei Han ◽  
Peikun Li ◽  
Xianwen Hu ◽  
Ye Zhang

Abstract Background: Recurrence of secondary hyperparathyroidism (SHPT) remains a big challenge in uremic patients who underwent total parathyroidectomy with auto-transplantation (tPTX-AT). However, the relationship between perioperative intervention and recurrence of SHPT remains unclear. Dexmedetomidine has been used safely and effectively in uremic patients’ anesthesia. The aim of the study was to explore the effect of dexmedetomidine on the recurrence of SHPT and speculate the possible mechanism of action.Methods: Records of patients who underwent tPTX-AT between 2017 and 2018 were retrospectively analyzed. The study consisted of patients who received dexmedetomidine intra-operatively and the controls were patients who did not receive dexmedetomidine. The primary endpoint was the difference in the recurrence of SHPT one year after surgery between the two groups. The secondary endpoint was health-related quality of life scores. Analysis included propensity score matching and multivariable logistic regression. Results: Of 354 patients, 133 patients received dexmedetomidine intraoperatively, and the total recurrence rate of SHPT was 10.2%. After propensity score matching, patients who received dexmedetomidine had a 3.80-fold decreased risk of SHPT recurrence (odds ratio, 0.263; 95% confidence interval, 0.081 to 0.854; P=0.026) and exhibited a better quality of life in terms of physical functioning and general health, and less emotional role limitations compared with those in control group.Conclusion: In uremic patients who received tPTX-AT, there was an association between dexmedetomidine use and decreased risk of SHPT recurrence. Further studies are needed to accurately assess the effects and mechanism of action of dexmedetomidine on the prognosis of this population.

2021 ◽  
Vol 7 (4) ◽  
pp. 469-473
Author(s):  
Ting Fang ◽  
Nian Wang ◽  
Meng Chen ◽  
Hongmei Ma

Objective Explore the impact of personalized nursing services and hospice care on the quality of life of elderly patients with advanced cancer. Method We selected 80 elderly cancer patients admitted to our hospital from September 2020 to May 2021, and divided these patients into a study group and a control group using a random number table method. The patients in the control group used conventional nursing methods to treat and care for the patients, and the patients in the study group used hospice care measures and combined personalized nursing measures. The quality of life and pain treatment effects of the two groups of patients before and after treatment were compared. Result Before treatment, the quality-of-life scores of the two groups of patients were low, and there was no statistical difference (P>0.05); After treatment, the quality of life of the two groups of patients improved, but compared with the control group, the improvement was more obvious in the study group, and the difference was statistically significant (P<0.05). In terms of pain treatment effect, the total effective rate of pain treatment in the study group was 87.5%, which was significantly better than the 62.5% in the control group. The difference was statistically significant (P<0.05). Conclusion Personalized nursing services and hospice care are conducive to improving the survival and treatment of elderly patients with advanced cancer, and can be used as a clinical application program for the care of advanced cancer patients.


2021 ◽  
Vol 9 (4) ◽  
pp. 75
Author(s):  
Weijie Qi

<p>Objective: to analyze the effect of health education intervention in clinical nursing of patients with skin diseases. Methods: from January 2018 to March 2019, 122 patients with skin diseases were admitted to our hospital and randomly divided into two groups, with 61 cases in each group. The selected patients gave informed consent to this study. The control group was given routine dermatological care, and the observation group was given systematic health education. The treatment effect, mood score and quality of life score of the two groups were compared. Results: the treatment time, recurrence times and outpatient treatment times of the observation group were lower than those of the control group, the difference was statistically significant (P &lt; 0.05); the HAMA score and HAMD score of the observation group after intervention were lower than the control group, the difference was statistically significant (P &lt; 0.05). Conclusion: the implementation of health education for patients with skin diseases during the nursing process can effectively promote the recovery of the condition and reduce the number of treatments and recurrences. At the same time, it can improve the patients’ bad mental mood and improve the quality of life of the patients.</p>


2017 ◽  
Vol 3 (2) ◽  
pp. 38
Author(s):  
Sinta Fresia

Abstrak Latar Belakang : Terjadinya peningkatan jumlah pasien HIV/AIDS dan rendahnya kualitas hidup pasien HIV/AIDS menimbulkan masalah yang cukup luas pada individu yang terinfeksi yakni masalah fisik, social dan emosional.Untuk meningkatkan kualitas dan harapan hidup pasien HIV/AIDS harus mendapatkan terapi Antiretrovirus (ARV) seumur hidup dan dibutuhkan pengawasan terhadap kepatuhan minum obat.Oleh karena itu pasien HIV/AIDS membutuhkan edukasi untuk meningkatkan kepatuhan minum obat dengan metode terbaru yaitu tutorial dan audiovisual.Tujuan penelitian ini untuk menganalisa perbedaan efektivitas pemberian edukasi berbasis audiovisual dan tutorial tentang ARV terhadap kepatuhan pengobatan pasien HIV/ AIDS. Metode : Penelitian ini menggunakan desain Quasi eksperimental dengan rancangan pretest-posttes design without control group.Jumlah sampel 27 responden dibagi 3 kelompok dengan 3 perlakuan berbeda.Masing-masing 9 responden diberikan edukasi dengan metode audiovisual, tutorial, audiovisual dan tutorial.Penelitian dilakukan di Klinik Teratai Rumah Sakit Hasan Sadikin Bandung pada bulan Mei-Juni 2016. Hasil : Ada perbedaan rata-rata mean kepatuhan edukasi dengan audiovisual 2,444, (Pvalue=0,003, 95% CI=1,107-3,782), edukasi dengan metode tutorial perbedaan mean 1,556 (Pvalue=0,023, 95% CI=1,274-2,837), edukasi dengan audiovisual dan tutorial didapatkan perbedaan mean 3,667 (Pvalue=0,003, 95% CI=1,670-5,664). Kesimpulan : Terdapat perbedaan yang significant rata-rata kepatuhan pada masing-masing kelompok intervensi edukasi.Kombinasi edukasi berbasis audiovisual dan tutorial memberikan hasil yang paling baik. Abstract Background : An increasing number of patients with HIV/AIDS and low quality of life of patients with HIV/AIDS cause considerable problems in individuals infected area.There are physical, social and emotional problems.To improve the quality of life of receive antiretroviral (ARV) therapy for life.This requires adherence and supervision taking medication. There fore urgently needed education to improve adherence with the latest audiovisual and tutorial methods. The purpose of this research is to analyze the difference effectiveness of education based audiovisual and tutorial method on ARV treatment adherence with HIV/AIDS patients.Methods : This research use quasi experimental design with pretest and posttest without control group. The numbers of sample in this research is 27 sample. Responden group divided into three different education methode. 9 responden in audiovisual methode,9 responden in tutorial methode and 9 responden in audiovisual and tutorial methode. The study was conducted at the Clinic Teratai Hasan Sadikin Hospital in May-June, 2016. Results : There is a diference in average adherence. In audiovisual methode mean 2,444 (Pvalue=0,003, 95% CI=1,107-3,782), tutorial methode 1,556(Pvalue=0,023, 95% CI=1,274-2,837), audiovisual and tutorial methode mean 3,667 (Pvalue =0,003, 95% CI=1,670-5,664).Conclusion : There is a significant difference in the average adherence in difference methode.Especially in audiovisual and tutorial methode. The combination of audiovisual and tutorial-based education gives the best results


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Haiyang Zhao ◽  
Zhiqiang Ren ◽  
Guangwen Wang

Objective. To observe the clinical effects of Jiawei Danggui Beimu Kushen pills in treating prostate cancer and their influence on the expression of serum prostate specific antigen. Methods. A total of 234 prostate cancer patients were selected and randomly divided into observation group and control group, with 117 cases in each group. The control group was given oral bicalutamide tablets, while the observation group was treated with Jiawei Danggui Beimu Kushen pills on the basis of the control group. The treatment efficacy, IPSS score, TCM syndrome score, VAS score, quality-of-life score, and immune function of the two groups were compared before and after treatment. The serum PSA and f-PSA levels of patients before treatment and after 30 days, 90 days, and 180 days of treatment in the two groups were compared. The five-year cumulative survival rate and the incidence of adverse reactions were compared between the two groups. Results. After treatment, the total effective rate of the observation group was 88.03% (103/117), which was higher than that of the control group 69.23% (81/117); the difference was statistically significant ( P < 0.05 ). After treatment, the IPSS score, TCM syndrome score, and VAS score of the two groups were reduced, and those in the observation group were lower than those in the control group; the difference was statistically significant ( P < 0.05 ). After treatment, the quality-of-life scores of the two groups increased, and the observation group was higher than the control group; the difference was statistically significant ( P < 0.05 ). Before treatment, there was no significant difference in serum PSA levels and f-PSA levels when comparing between the two groups of patients ( P > 0.05 ). With the increase of treatment time, the two index levels of the two groups were gradually decreased. After 180 days of treatment, the two index levels of the two groups of patients were significantly lower than those before treatment, and the two index levels of the observation group were significantly lower than those of the control group; the difference was statistically significant ( P < 0.05 ). After treatment, the levels of IgM and IgA in the two groups were decreased, and the level of IgG was increased. The difference between the two groups in the levels of each index before and after treatment was statistically significant ( P < 0.05 ), and the difference between the two groups in the levels of each index after treatment was also statistically significant ( P < 0.05 ). The five-year cumulative survival rate of the observation group was 69.23%, and the five-year cumulative survival rate of the control group was 46.15% ( P < 0.05 ). There was no statistically significant difference between the two groups in the incidence of dizziness, fatigue, and gastrointestinal reactions ( P > 0.05 ), but the difference in the incidence of dysuria as well as dysuria and hematuria was statistically significant ( P < 0.05 ). Conclusion. Jiawei Danggui Beimu Kushen pills are effective in treating prostate cancer, which can effectively reduce the patients’ IPSS score and TCM syndrome scores, relieve the pain, and improve the quality of life of patients. They also have a potential role in regulating serum PSA levels, clearing tumor lesions, reducing postoperative complications, and improving related symptoms.


2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Wei Zheng ◽  
Xiang Yan ◽  
Xiaoxue Song

Objective: To study and analyze the clinical efficacy of gemcitabine combined with Tegafur chemotherapy after radical resection of pancreatic cancer. Methods: The subjects of the study were 200 patients who were admitted to the hospital from January 2018 to February 2021 requiring chemotherapy after radical resection of pancreatic cancer. According to the different treatment methods, they were divided into a experimental group (gemcitabine combined with Tegafur chemotherapy) and a control group (single gemcitabine chemotherapy), and the treatment efficacy of the two groups of patients was observed and compared. Results: Compared with the control group, patients in the experimental group had significantly better treatment efficacy, quality of life scores and post-treatment anxiety and depression scores. The difference between the groups was significant (p<0.05). Conclusion: Gemcitabine combined with Tegafur chemotherapy for patients requiring chemotherapy after radical resection of pancreatic cancer can significantly improve the treatment efficacy for the disease, improve the patient's quality of life, and ensure that the patient's emotional state during treatment is more positive.


2021 ◽  
Vol 70 (1) ◽  
pp. 12-14
Author(s):  
Petr Schalek ◽  
Jakub Fuksa ◽  
Anasuya Guha ◽  
Martin Chovanec

Introduction: The prevalence of chronic rhinosinusitis with nasal polyps (CRSwNP) in the population is estimated at 4%. If adequate conservative treatment fails to improve the quality of life, patients are indicated for surgical therapy, which is represented by a functional endonasal surgery. The recurrence of polyps after surgery is reported by up to 60% in some studies. At the moment, available data does not indicate the optimal extent of surgery, especially in the case of revision procedures. The aim of the presented study was to find out whether a more radical revision surgery, including Draf 3-type (D3) frontal sinotomy, could be beneficial for patients with recurrent disease. Material and methods: Forty-two patients with recurrent polyposis were included in a retrospective case-control study. Half of the patients had undergone a more radical procedure including D3, while the control group had a standard operation. In both groups, the quality of life was assessed using the Czech version of the SNOT-22 questionnaire, the incidence of polyp recurrence and the need for revision within 2 years after the operation. Results: The presented study recorded lower postoperative values of postoperative SNOT-22 questionnaire in patients with D3 frontal sinotomy, but the difference was not statistically significant compared to the group of patients after traditional FES. A significantly lower need for revision surgery was proved in patients with more radical surgery. Conclusion: These data suggest that more radical surgical procedure in a subgroup of patients with severe recurrent polyps may be beneficial for these patients.


2021 ◽  
Vol 7 (5) ◽  
pp. 3320-3324
Author(s):  
Ting Fang ◽  
Nian Wang ◽  
Meng Chen ◽  
Hongmei Ma

Objective Explore the impact of personalized nursing services and hospice care on the quality of life of elderly patients with advanced cancer. Method We selected 80 elderly cancer patients admitted to our hospital from September 2020 to May 2021, and divided these patients into a study group and a control group using a random number table method. The patients in the control group used conventional nursing methods to treat and care for the patients, and the patients in the study group used hospice care measures and combined personalized nursing measures. The quality of life and pain treatment effects of the two groups of patients before and after treatment were compared. Result Before treatment, the quality-of-life scores of the two groups of patients were low, and there was no statistical difference (P>0.05); After treatment, the quality of life of the two groups of patients improved, but compared with the control group, the improvement was more obvious in the study group, and the difference was statistically significant (P<0.05). In terms of pain treatment effect, the total effective rate of pain treatment in the study group was 87.5%, which was significantly better than the 62.5% in the control group. The difference was statistically significant (P<0.05). Conclusion Personalized nursing services and hospice care are conducive to improving the survival and treatment of elderly patients with advanced cancer, and can be used as a clinical application program for the care of advanced cancer patients.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1774.1-1775
Author(s):  
A. Keskin ◽  
B. Basakci Calik ◽  
E. Gur Kabul ◽  
V. Cobankara

Background:Fibromyalgia (FM) is a systemic rheumatic disease characterized by diffuse pain in the body, tenderness, fatigue and many more symptoms. Exercise is effective and safe method in individuals with FM. Connective tissue massage, another treatment method, is a reflex therapy where shear force is applied in a certain order at the connective tissue interfaces of the skin. In the literature, there is limited study releted compared with clinical pilates exercises and connective tissue massage in individuals with FM.Objectives:The aim of the study was to examine the effectiveness of clinical pilates exercises and connective tissue massage in Individuals with Fibromyalgia on disease activity, number of painful regions, anxiety, biopsychosocial status and quality of life.Methods:32 women (age mean=52.43±8.32) diagnosed with FM according to American College of Rheumatology (ACR) criteria were included in this study. Participants were randomly divided into two groups as interventional group (n=15, mean age=48.80±7.48) and control group (n=17, mean age=55.64±7.87). While the connective tissue massage and clinical pilates exercises were applied to the treatment group, only clinical pilates exercises were applied to the control group. After the demographic characteristics and disease related data of the individuals were recorded; number of painful regions were assessed with Pain Location Inventory (PLI), disease impact with Fibromyalgia Impact Questionnare (FIQ), functional status with Health Assessment Questionnare (HAQ), anxiety with Beck Anxiety Inventory (BAI), quality of life with Short Form-36 (SF-36) and biopsychosocial status with Cognitive Exercise Therapy Approach (BETY) Scale were evaluated. All evaluations were made before and after treatment. All interventions were applied 3 days per week for 6 weeks by the same experienced physical therapist. One session for clinical pilates exercises consisted of 60 minutes (10 minutes warm up, 40 minutes clinical pilates exercises, 10 minutes cool-down). Connective tissue massage was started from lumbosacral region and continued lower thoracic, scapular, interscapular, and cervical regions, respectively. The Kolmogorov-Smirnov Test was used to determine whether the continuous variables were normal distributions.Results:When the pre-treatment and post-treatment results are analyzed; the results were significant in the intervention group of PLI (p = 0.007), SF 36 physical component (p = 0.025) and mental component (p = 0.017) and FIQ (p = 0.004), while in the control group the difference in SF 36 physical component (p = 0.008) and mental component (p = 0.024), FIQ (p = 0.001) and BAI (p = 0.043) was significant. Delta values were calculated by subtracting post-treatment results from pre-treatment results. When the delta values of the groups are compared, it was determined that the difference only in the PLI (p = 0.023) were significant in favor of the treatment group.Conclusion:According to our results, connective tissue massage has been shown to be effective in reducing the number of painful areas in addition to the positive effects of clinical pilates exercises in individuals with FM. In order to increase the effectiveness of treatment in individuals with FM, we recommend the use of connective tissue massage as an additional treatment method.References:[1]Busch, Angela J., et al. Exercise therapy for fibromyalgia. Current pain and headache reports 2011;15: 358.[2]Burckhardt CS. Nonpharmacologic management strategies in fibromyalgia. Rheumatic diseases clinics of North America, 2002, 28(2),291-304.Disclosure of Interests:None declared


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