BACKGROUND There is still some room for optimizing ambulatory pediatric surgical procedures,and the preoperative and postoperative management quality for pediatric patients needs to be improved.AIM To discuss the safe...BACKGROUND There is still some room for optimizing ambulatory pediatric surgical procedures,and the preoperative and postoperative management quality for pediatric patients needs to be improved.AIM To discuss the safety and feasibility of the enhanced recovery after surgery(ERAS)-based management model for ambulatory pediatric surgical procedures.METHODS We selected 320 pediatric patients undergoing ambulatory surgery from June 2023 to January 2024 at The First People’s Hospital of Liangshan Yi Autonomous Prefecture.Of these,220 received ERAS-based management(research group)and 100 received routine management(control group).General information,postoperative ambulation activities,surgical outcomes(operation time,postoperative gastro-intestinal ventilation time,and hospital stay),postoperative pain visual analogue scale,postoperative complications(incision infection,abdominal distension,fever,nausea,and vomiting),and family satisfaction were compared.RESULTS The general information of the research group(sex,age,disease type,single parent,family history,etc.)was comparable to that of the control group(P>0.05),but the rate of postoperative(2 h,4 h,and 6 h after surgery)ambulation activities was statistically higher(P<0.01),and operation time,postoperative gastrointestinal ventilation time,and hospital stay were markedly shorter(P<0.05).The research group had lower visual analogue scale scores(P<0.01)at 12 h and 24 h after surgery and a lower incidence of total postoperative complications than the control group(P=0.001).The research group had higher family satisfaction than the control group(P=0.007).CONCLUSION The ERAS-based management model was safe and feasible in ambulatory pediatric surgical procedures and worthy of clinical promotion.展开更多
The risk of peritonitis complications in continuous ambulatory peritoneal dialysis(CAPD)can be prevented or reduced by providing proper education and continuous monitoring.Telemedicine and telemonitoring are methods t...The risk of peritonitis complications in continuous ambulatory peritoneal dialysis(CAPD)can be prevented or reduced by providing proper education and continuous monitoring.Telemedicine and telemonitoring are methods that enable remote monitoring and patient care.This study aimed to determine the success and factors affecting telemonitoring in CAPD patient care.This study is a scoping review(ScR)using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-ScR method.Article searches were carried out on ProQuest,PubMed,and ScienceDirect with a time range of 2018-2023.Data extraction was performed regarding knowledge level,quality of life,clinical outcomes(peritonitis),and risk of hospitalization.Of the 12 articles and studies included,6 articles were related to the effect of telemonitoring on CAPD patient outcomes,and 6 articles were associated with the effect of education on CAPD patient outcomes.Education provided to patients can improve patient understanding of therapeutic modalities for renal disorders,reduce the potential for peritonitis and dialysis complications,and improve the quality of life of patients with CAPD.CAPD patients who received telemonitoring had a better quality of life,good clinical outcomes,and a lower risk of hospitalization than those who did not receive telemonitoring and had fewer health-care visits.In summary,the implementation of telemonitoring and education in chronic kidney disease patients with CAPD modality therapy has been proven effective in improving quality of life and reducing dialysis-related risks.展开更多
Objective:To study clinical significance of early postinfarctionischemia by ambulatory electrocardiographic monitoring(AEM).Methods:There were 64 petients with acute myocardial infarction(AMI).43 males,21 females,with...Objective:To study clinical significance of early postinfarctionischemia by ambulatory electrocardiographic monitoring(AEM).Methods:There were 64 petients with acute myocardial infarction(AMI).43 males,21 females,with a mean age of 61 years.Among of them,31 were anteriormyocardial infarction(MI),26 were inferior HI,7 were HI with botbanterior and inferior,All patlents were contintinueouslyonitored for5-12 days,The judging criteria were①ST segment depressed≥0.1andlasted for≥1 minute②The time interval between two ischemia attacks】1 minute.Results:Of all patients,46 showed postinfarction ischemia(PII)(72%),17 of them with symptom of postinfarction angina(PIA)(37%),29 of them without any symptom(63%).The incidence of PII within a weekafter infarction is 83%.These patients’incidence of arrhythimia,heartfallure,and cardiogenic shock are 90.24%,68.29%,and 19.51% respective-ly,which are much higher than that of those without PII attack.Discussion:The occurrence of PIA indicates relapsing myocardialischemia,and coronary angiography has confirmed a great degree ofstenosis with coronary artery.The exist of PII is one of theIndependent dan factors of bad prognosis of coronary heartdisease.It has been confirmed by other articles that ischemis mayexist whether PIA occurs or not,and the ircidence of ischemia withoutsymptom is higher,having the same result with this one.The depressionof ST segment can sensltively show ischemia So we must pay attentionto the change of ST segment in early stage of AMI.By AEM,we can findthat PII has different appearances and incidence with differentinfarction position and infarction range,and its occurrence has timedistribution,part of them are related to the activities of patients.Ischemia occurs more frequently in patients with anterior HI thanthose with inferior MI.The more extensive infarction,the higherincidence of ischemia,and the incidence of all kinds of complicationsand the mortality rate are higher in those with PII than those withoutit.Weiner D.A etc.also had similar reports.So we must strengthen themonitoring to the patients with PII to lay out individual cure planaccording to different attack characteristics,when necessary,we shouldtake coronary angiography to make PTCA or CABG.展开更多
Background: 25% of all people requiring surgical care are not able to access it due to its high cost. These people stand a high risk of preventable severe morbidity and mortality due to poor prognosis of surgically co...Background: 25% of all people requiring surgical care are not able to access it due to its high cost. These people stand a high risk of preventable severe morbidity and mortality due to poor prognosis of surgically correctable illnesses. Ambulatory surgical care services are significantly cheaper than orthodox surgical care and have become very relevant in this time and age where health conditions that can only be treated with surgical intervention are on the rise. The acceptability of ambulatory surgical care services will determine how this model increases universal health coverage. Objective: To assess the acceptability of ambulatory surgical services and its predictors among residents of Budondo Sub-County—Jinja district. Methods: The study was cross-sectional targeting 371 household heads in Budondo Sub-County, which was stratified by parish, with villages in each randomly sampled. Systematic random sampling was used to sample households and households therein were purposively sampled. Structured interviews and questionnaires were the data collection techniques, and data was analyzed in SPSS version 25 using descriptive statistics and a binomial logit model. Results: The level of acceptability of ambulatory surgical care services among residents of Budondo Sub-County was found to be near-universal, at 96.5%. The odds of accepting ambulatory surgical care were least among household heads who agreed that surgery done in a hospital would be cheaper than surgery done at community level (aOR = 0.174 [CI = 0.055 - 0.553]), those who had health insurance (aOR = 0.105 [95% CI = 0.030 - 0.371]), and household heads who were covered with private health insurance (aOR = 0.078 [95% CI = 0.008 - 0.792]). Acceptability of ASC was higher among household heads who agreed that they would trust ambulatory surgical centers with their life were more likely to accept ambulatory surgical care (aOR = 1.124, [95% CI = 1.122 - 3.218], P = 0.000), and household heads from households that had less than five members with surgery history were twice as likely to accept ambulatory surgical care (aOR = 2.431 [95% CI = 1.122 - 5.898], P = 0.000). Conclusion: Acceptability of ambulatory surgical care services among residents of Budondo Sub-County is high, and near-universal. It is mainly predicted by intrapersonal correlates and to a small extent by socio-demographic characteristics, with the implication that the administration of Global Surgical Initiatives in Kyabirwa ought to focus on modifying or uphold the intrapersonal characteristics found to be antagonists and protagonists of acceptability, respectively.展开更多
Introduction: Ambulatory Blood Pressure Measurement (ABPM) is a non- invasive examination recommended for subjects at high cardiovascular risk, and those requiring a nocturnal drop in BP such as elderly and obese...Introduction: Ambulatory Blood Pressure Measurement (ABPM) is a non- invasive examination recommended for subjects at high cardiovascular risk, and those requiring a nocturnal drop in BP such as elderly and obese subjects, those with secondary hypertension or resistant, diabetics, subjects with metabolic syndrome or sleep apnea syndrome. The objective of this study was to evaluate the contribution of ABPM in the diagnosis and evaluation of the level of control of hypertension under treatment at the Bel Air international clinic. Materials and Methods: This is a retrospective, cross-sectional and descriptive study, carried out at the Bel Air International Clinic in Conakry (Guinea) between January 2019 and November 30, 2022. It included a consecutive series of 180 consenting patients recruited through an ambulatory measurement of 24-hour blood pressure from a FUGADA brand device. Results: We collected 180 patients, with a male predominance (sex-ratio M/F = 2.46). The mean age of the patients was 48.48 ± 14.23 years. The most represented age group was that of 32 to 42 years with 50 cases (27.8%) followed by that of 43 to 52 years with 42 cases or 23.3%. The indication was for diagnostic purposes in 106 cases 58.9%, the therapeutic evaluation in 58 patients (32.2%). The examination was prescribed by a cardiologist in 98 cases (54.4%), a general practitioner in 71 cases (39.4%), a neurologist in 11 cases (6.1%). In the therapeutic evaluation, high blood pressure was controlled in 24 patients (13.3%) and uncontrolled in 34 cases (18.9%). In the diagnostic indication, high blood pressure was confirmed in 79 cases (43.9%) with a statistically significant link (Chi2</sup> = 4.57 and p-value = 0.032). The nycthemeral mean was 187.27 ± 26.22 mmHg for systolic blood pressure (SBP) and 110.37 ± 19.06 mmHg for diastolic blood pressure (DBP), during the day, 151.64 ± 21.45 mmHg for SBP and 71.59 ± 8.67 mmHg for diastolic blood pressure. During the study 65 patients (36.1%) were identified as dippers and 115 patients (63.9%) were no-dipping. The antihypertensive protocol used was monotherapy in 68 cases (37.8%), dual therapy in 46 cases (25.6%), triple therapy in 17 cases (9.4%). However 39 patients or 21.7% were not taking any antihypertensive. Conclusion: This preliminary study, despite the modest sample size, showed the importance of ABPM as a tool for diagnosis, monitoring of hypertensive patients and therapeutic adaptation. A large-scale national study would be necessary for the rational use of ambulatory blood pressure measurement in our context in order to improve the management of hypertensive patients.展开更多
基金Supported by Liangshan Prefecture Science Research,Development,Promotion and Application Project Application Form,No.17yyjs0011.
文摘BACKGROUND There is still some room for optimizing ambulatory pediatric surgical procedures,and the preoperative and postoperative management quality for pediatric patients needs to be improved.AIM To discuss the safety and feasibility of the enhanced recovery after surgery(ERAS)-based management model for ambulatory pediatric surgical procedures.METHODS We selected 320 pediatric patients undergoing ambulatory surgery from June 2023 to January 2024 at The First People’s Hospital of Liangshan Yi Autonomous Prefecture.Of these,220 received ERAS-based management(research group)and 100 received routine management(control group).General information,postoperative ambulation activities,surgical outcomes(operation time,postoperative gastro-intestinal ventilation time,and hospital stay),postoperative pain visual analogue scale,postoperative complications(incision infection,abdominal distension,fever,nausea,and vomiting),and family satisfaction were compared.RESULTS The general information of the research group(sex,age,disease type,single parent,family history,etc.)was comparable to that of the control group(P>0.05),but the rate of postoperative(2 h,4 h,and 6 h after surgery)ambulation activities was statistically higher(P<0.01),and operation time,postoperative gastrointestinal ventilation time,and hospital stay were markedly shorter(P<0.05).The research group had lower visual analogue scale scores(P<0.01)at 12 h and 24 h after surgery and a lower incidence of total postoperative complications than the control group(P=0.001).The research group had higher family satisfaction than the control group(P=0.007).CONCLUSION The ERAS-based management model was safe and feasible in ambulatory pediatric surgical procedures and worthy of clinical promotion.
文摘The risk of peritonitis complications in continuous ambulatory peritoneal dialysis(CAPD)can be prevented or reduced by providing proper education and continuous monitoring.Telemedicine and telemonitoring are methods that enable remote monitoring and patient care.This study aimed to determine the success and factors affecting telemonitoring in CAPD patient care.This study is a scoping review(ScR)using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-ScR method.Article searches were carried out on ProQuest,PubMed,and ScienceDirect with a time range of 2018-2023.Data extraction was performed regarding knowledge level,quality of life,clinical outcomes(peritonitis),and risk of hospitalization.Of the 12 articles and studies included,6 articles were related to the effect of telemonitoring on CAPD patient outcomes,and 6 articles were associated with the effect of education on CAPD patient outcomes.Education provided to patients can improve patient understanding of therapeutic modalities for renal disorders,reduce the potential for peritonitis and dialysis complications,and improve the quality of life of patients with CAPD.CAPD patients who received telemonitoring had a better quality of life,good clinical outcomes,and a lower risk of hospitalization than those who did not receive telemonitoring and had fewer health-care visits.In summary,the implementation of telemonitoring and education in chronic kidney disease patients with CAPD modality therapy has been proven effective in improving quality of life and reducing dialysis-related risks.
文摘Objective:To study clinical significance of early postinfarctionischemia by ambulatory electrocardiographic monitoring(AEM).Methods:There were 64 petients with acute myocardial infarction(AMI).43 males,21 females,with a mean age of 61 years.Among of them,31 were anteriormyocardial infarction(MI),26 were inferior HI,7 were HI with botbanterior and inferior,All patlents were contintinueouslyonitored for5-12 days,The judging criteria were①ST segment depressed≥0.1andlasted for≥1 minute②The time interval between two ischemia attacks】1 minute.Results:Of all patients,46 showed postinfarction ischemia(PII)(72%),17 of them with symptom of postinfarction angina(PIA)(37%),29 of them without any symptom(63%).The incidence of PII within a weekafter infarction is 83%.These patients’incidence of arrhythimia,heartfallure,and cardiogenic shock are 90.24%,68.29%,and 19.51% respective-ly,which are much higher than that of those without PII attack.Discussion:The occurrence of PIA indicates relapsing myocardialischemia,and coronary angiography has confirmed a great degree ofstenosis with coronary artery.The exist of PII is one of theIndependent dan factors of bad prognosis of coronary heartdisease.It has been confirmed by other articles that ischemis mayexist whether PIA occurs or not,and the ircidence of ischemia withoutsymptom is higher,having the same result with this one.The depressionof ST segment can sensltively show ischemia So we must pay attentionto the change of ST segment in early stage of AMI.By AEM,we can findthat PII has different appearances and incidence with differentinfarction position and infarction range,and its occurrence has timedistribution,part of them are related to the activities of patients.Ischemia occurs more frequently in patients with anterior HI thanthose with inferior MI.The more extensive infarction,the higherincidence of ischemia,and the incidence of all kinds of complicationsand the mortality rate are higher in those with PII than those withoutit.Weiner D.A etc.also had similar reports.So we must strengthen themonitoring to the patients with PII to lay out individual cure planaccording to different attack characteristics,when necessary,we shouldtake coronary angiography to make PTCA or CABG.
文摘Background: 25% of all people requiring surgical care are not able to access it due to its high cost. These people stand a high risk of preventable severe morbidity and mortality due to poor prognosis of surgically correctable illnesses. Ambulatory surgical care services are significantly cheaper than orthodox surgical care and have become very relevant in this time and age where health conditions that can only be treated with surgical intervention are on the rise. The acceptability of ambulatory surgical care services will determine how this model increases universal health coverage. Objective: To assess the acceptability of ambulatory surgical services and its predictors among residents of Budondo Sub-County—Jinja district. Methods: The study was cross-sectional targeting 371 household heads in Budondo Sub-County, which was stratified by parish, with villages in each randomly sampled. Systematic random sampling was used to sample households and households therein were purposively sampled. Structured interviews and questionnaires were the data collection techniques, and data was analyzed in SPSS version 25 using descriptive statistics and a binomial logit model. Results: The level of acceptability of ambulatory surgical care services among residents of Budondo Sub-County was found to be near-universal, at 96.5%. The odds of accepting ambulatory surgical care were least among household heads who agreed that surgery done in a hospital would be cheaper than surgery done at community level (aOR = 0.174 [CI = 0.055 - 0.553]), those who had health insurance (aOR = 0.105 [95% CI = 0.030 - 0.371]), and household heads who were covered with private health insurance (aOR = 0.078 [95% CI = 0.008 - 0.792]). Acceptability of ASC was higher among household heads who agreed that they would trust ambulatory surgical centers with their life were more likely to accept ambulatory surgical care (aOR = 1.124, [95% CI = 1.122 - 3.218], P = 0.000), and household heads from households that had less than five members with surgery history were twice as likely to accept ambulatory surgical care (aOR = 2.431 [95% CI = 1.122 - 5.898], P = 0.000). Conclusion: Acceptability of ambulatory surgical care services among residents of Budondo Sub-County is high, and near-universal. It is mainly predicted by intrapersonal correlates and to a small extent by socio-demographic characteristics, with the implication that the administration of Global Surgical Initiatives in Kyabirwa ought to focus on modifying or uphold the intrapersonal characteristics found to be antagonists and protagonists of acceptability, respectively.
文摘Introduction: Ambulatory Blood Pressure Measurement (ABPM) is a non- invasive examination recommended for subjects at high cardiovascular risk, and those requiring a nocturnal drop in BP such as elderly and obese subjects, those with secondary hypertension or resistant, diabetics, subjects with metabolic syndrome or sleep apnea syndrome. The objective of this study was to evaluate the contribution of ABPM in the diagnosis and evaluation of the level of control of hypertension under treatment at the Bel Air international clinic. Materials and Methods: This is a retrospective, cross-sectional and descriptive study, carried out at the Bel Air International Clinic in Conakry (Guinea) between January 2019 and November 30, 2022. It included a consecutive series of 180 consenting patients recruited through an ambulatory measurement of 24-hour blood pressure from a FUGADA brand device. Results: We collected 180 patients, with a male predominance (sex-ratio M/F = 2.46). The mean age of the patients was 48.48 ± 14.23 years. The most represented age group was that of 32 to 42 years with 50 cases (27.8%) followed by that of 43 to 52 years with 42 cases or 23.3%. The indication was for diagnostic purposes in 106 cases 58.9%, the therapeutic evaluation in 58 patients (32.2%). The examination was prescribed by a cardiologist in 98 cases (54.4%), a general practitioner in 71 cases (39.4%), a neurologist in 11 cases (6.1%). In the therapeutic evaluation, high blood pressure was controlled in 24 patients (13.3%) and uncontrolled in 34 cases (18.9%). In the diagnostic indication, high blood pressure was confirmed in 79 cases (43.9%) with a statistically significant link (Chi2</sup> = 4.57 and p-value = 0.032). The nycthemeral mean was 187.27 ± 26.22 mmHg for systolic blood pressure (SBP) and 110.37 ± 19.06 mmHg for diastolic blood pressure (DBP), during the day, 151.64 ± 21.45 mmHg for SBP and 71.59 ± 8.67 mmHg for diastolic blood pressure. During the study 65 patients (36.1%) were identified as dippers and 115 patients (63.9%) were no-dipping. The antihypertensive protocol used was monotherapy in 68 cases (37.8%), dual therapy in 46 cases (25.6%), triple therapy in 17 cases (9.4%). However 39 patients or 21.7% were not taking any antihypertensive. Conclusion: This preliminary study, despite the modest sample size, showed the importance of ABPM as a tool for diagnosis, monitoring of hypertensive patients and therapeutic adaptation. A large-scale national study would be necessary for the rational use of ambulatory blood pressure measurement in our context in order to improve the management of hypertensive patients.