Post-Endoscopy Self-Limited Unspecified Fever: Rare or Common Adverse Event after Endoscopy?—An Observational, Cross-Sectional Study

Background: Although post-endoscopy fever (PEF) without colon perforation or haemorrhage is believed to be rare, incidence, risk factors and causes in the adult population have not been fully investigated. The purpose of the present study was to investigate the incidence of PEF and identify the risk factors associated with the development of PEF and its outcomes. Material and Methods: Over a three-month period, 1054 non-hospitalised patients who had an endoscopic procedure at Cleveland Clinic Abu Dhabi received a post-procedure phone call within the first 24 hours. After identifying patients with fever and obtaining verbal consent, patients were enrolled in the study using a standardised telephone interview. Results: Thirty-four patients with PEF were identified. The highest temperature measured was 39.8 degrees Celsius. Oesophagogastroduodenoscopy, as a single procedure, was the most commonly performed (41.2%). Logistic regression revealed that no significant group differences across procedure types existed in terms of adjusted odds of fever. However, results also indicated that age has a significant negative relationship with fever—higher age is associated with lower odds of fever (b = -0.033, p = 0.024). Conclusion: PEF is an unpleasant side effect and it is associated with patient discomfort, dissatisfaction and fear during post-endoscopy recovery. Although our findings do not fully explain the possible mechanisms underlying post-endoscopy fever, this study data should increase awareness about PEF as a common side effect related to endoscopy.

Predictive factors for the post embolization fever after transcatheter arterial chemoembolization in hepatocellular carcinoma patients:a single center study in China

Background and Objectives:Post embolization fever(PEF)is one of the most common symptoms of post embolization syndrome(PES).This study aimed to determine and validate a model to predict PEF after transcatheter arterial chemoembolization(TACE)in hepatocellular carcinoma(HCC)patients.Methods:Clinical data of HCC patients who underwent TACE with platinum was retrospectively collected in our center from 2017 to 2018.Predictive factors were screened by multivariate logistic regression.The accuracy and discriminative ability of these factors were evaluated by the receiver operating characteristic(ROC)curve using the derivation cohort and an independent validation cohort.Results:A total of 367 patients were included,of whom 53(14.4%)patients had PEF.Fevers were detected in 44 of 252 patients in the derivation cohort and 9 of 115 patients in the validation cohort.Predictors for PEF identified in multivariate logistic regression included Lipiodol emulsion dose(OR,1.081;95%CI,1.006-1.162),number of concomitants uses of hepatoprotectants(OR,0.619;95%CI,0.419-0.914),K+levels(OR,2.992;95%CI,1.225-7.308),and albumin-bilirubin(ALBI)grade(OR,2.249;95%CI,1.040-4.862).Furthermore,the area under the ROC curve of the derivation and validation cohorts were 0.798 and 0.874,respectively.Conclusions:Our study demonstrated that Lipiodol emulsion dose,number of concomitant uses of hepatoprotectants,K+levels,and ALBI grade are independent risk factors for PEF.The multivariate logistic model of these factors shows a discriminative ability to predict PEF in the patients who underwent TACE.

Abdominal Pain and Fever Indicative Postpartum Ovarian Vein Thrombosis: A Case Report

Introduction: OVT is rare, with an incidence of 0.05% to 0.18% and occurring preferentially in postpartum period. Any delay in management may compromise the patient’s vital prognosis. Observation: We report a case of a 34-year-old patient, G2P3, who delivered twins by cesarean section at 39 weeks of amenorrhea. She presented abdominal pain and fever on the 4th day of postpartum. Biological tests showed a biological inflammatory syndrome and a positive blood culture with gram-positive Staphylococcus. After 72 hours of antibiotics with no clinical or biological improvement, a CT scan revealed a 12 mm thrombus in the lumen of the right ovarian vein’s connection to the inferior vena cava. Antibiotic treatment was continued, associated with an anticoagulant. The evolution was been favorable. Conclusion: Rare and serious pathology, the diagnosis is made using medical imaging. The outcome is generally favorable with antibiotic therapy and anticoagulant therapy.

甘温除热法治疗乳腺癌化疗后并发症

乳腺癌的发病以气郁、痰凝、血瘀为因,患之日久,积聚为核,囿于乳络,终耗气伤血,应用化疗药物后,毒邪进入体内最先伤及脾胃,脾胃受损则气血生化无本,输布无源,进而影响其他脏腑生理功能,致正气虚损、气血耗伤。甘温除热法可扶正祛邪、调畅气机、补益气血、安和诸脏,病及于心可用泻火升阳汤,病及于肝可用补中益气汤,病及于肺可用升阳益胃汤,病及于肾可用神圣复气汤。临证时需把握甘温除热法对应证的病机变化,选用方除李东垣著作中所载方外,亦可选黄芪建中汤、人参养荣汤、十全大补汤、七味白术散等符合甘温除热思想之方。

Evaluation of Fever and Its Related Factors during 4 Weeks after Primary Total Hip Arthroplasty

The purpose of this study was to describe the incidence and characteristics of postoperative fever (POF;≥38℃) and clarify the correlation between POF and febrile-related factors during 4 weeks after primary total hip arthroplasty (THA). A total of 56 patients were included in the study (67 THAs). The preoperative diagnosis for all patients was osteoarthritis. The average follow-up period was 90 months. No patients developed deep infection during the follow-up period. The maximum mean peak daily temperature was 37.7℃ on the day of the surgery and the next day. Fifty-two percent of patients experienced POF, with most developing a maximum temperature (MT) on the day of surgery and the latest occurring by postoperative day (POD) 3. Only C-reactive protein (R = 0.384, p = 0.001) among the febrile-related factors had a weak correlation with MT. Four hips showed a POF of >38℃ later than POD 7;all four of these patients were diagnosed with a urinary tract infection. POF is common and may be part of a normal inflammatory response to tissue injury after THA. More than half of patients may develop POF within 1 week, with most developing MT on POD 0 and the latest occurring by POD 3. In addition, urinary tract infections might be an initial reason for POF in the subsequent 3 weeks.

小儿退热医用贴在甲状腺腺瘤摘除术后的应用观察

目的探讨小儿退热医用贴在甲状腺腺瘤摘除术后护理中的应用效果。方法选取甲状腺腺瘤摘除术患者50例,按随机自愿原则分为观察组和对照组。对照组术后常规护理,观察组除术后常规护理加小儿退热医用贴颈前冷敷。评价两组患者颈部肿胀消退的时间和疼痛评分值。结果观察组术后颈部肿胀消退时间明显短于对照组,观察组在术后24h、48h、72h3个不同的观察时间点疼痛程度明显低于对照组。结论小儿退热医用贴冷敷能明显减轻甲状腺腺瘤摘除术后颈部肿痛,有利于术后的恢复。

后疫情时代我国生猪产业发展的分析展望及对策建议

面对非洲猪瘟和新冠疫情的双重影响,为了给稳定生猪生产、保障市场供应提供参考,研究通过梳理我国生猪产业发展历程和政策背景,并根据2017—2020年我国生猪产业相关数据研判了我国当前生猪产业形势和未来趋势,分析了当前存在的主要问题。结果表明:我国生猪产业发展历经“大发展,小震荡”,整体发展较为迅速,非洲猪瘟疫情以后,在政府和市场的双重调节之下,我国生猪产能恢复势头良好,猪肉供应明显改善,市场行情持续较好;未来,我国猪肉的市场供应短期内将逐步增加,价格回归至合理水平,几年内或将迎来新的猪价时期;但仍面临疫病潜在风险较大、地方发展动力不足、养殖成本居高不下、生产效率进一步降低的问题。鉴于此,笔者提出了毫不松懈做好疫情防控、督促地方政府加大扶持力度和推进企业发展转型升级的对策建议。

活组织检查对纤维支气管镜检后发热的影响

目的:本研究旨在探讨活组织检查与纤维支气管镜(纤支镜)检后发热的发生率及相关关系。方法:对2013年1月-2013年12月在中国医科大学附属第一医院内镜中心因肺肿物行支气管镜检查的患者进行前瞻性对比研究,共入选586例,未行活组织检查者223例作为对照组,活组织检查者363例作为实验组。结果:实验组共363例患者,出现发热47例,发热率为12.95%,平均发热出现时间为(4.8±1.9)h,平均发热持续时间为(6.9±4.3)h,发热时平均最高体温为(37.8±0.4)℃;对照组223例,出现发热者23例,发热率为10.31%,平均发热出现时间为(5.0±2.4)h,平均发热持续时间为(5.7±2.5)h,发热时平均最高体温为(37.7±0.3)℃。镜检后发热患者白细胞计数及中性粒细胞比率较镜检前增高,但24h后基本恢复至正常水平。实验组与对照组发热患者之间中性粒细胞比率增高存在差异,且差异有统计学意义。结论:活检后中性粒细胞比率变化高于未行活检患者,差异有统计学意义,考虑可能是行活组织检查的患者可能更容易激活全身的炎症反应。

中医辨证治疗骨科术后非感染性发热的临床进展

骨科术后非感染性发热是临床上较常见的并发症之一，现代医学认为多于手术反应热、输血或输液反应热、药物热、脱水热等有关。发热多为低热，一般不超过38．5℃，无需特殊处理，治疗上常给予物理降温、解热镇痛等对症支持治疗。大多数患者治疗后发热缓解，但过后热势又起，反复发作，反复的发热往往引起患者与家属的紧张。中医辨证治疗骨科术后非感染性发热在临床取得了很好的效果。

后疫情时代发热门诊建设的思考与对策

本文简单梳理了我国医疗机构中发热门诊建设发展的历史,总结了"非典"和"新冠"两次疫情中在我国现行医疗管理和建设体制下发热门诊规划与建设中出现的问题,从医疗体制、规划建设等方面提出了未来常态化疫情防控背景下我国发热门诊建设的策略性思考。

探讨临床药师参与颅脑术后患者发热会诊临床药学思维

目的探讨临床药师在参与颅脑术后发热患者会诊中建立临床思维的重要性。方法针对颅脑术后发热患者,临床药师从发热原因分析着手,运用临床药学思维模式提出合理治疗方案,并进行药学监护。结果临床药师通过会诊、分析病因、参与制订治疗方案等途径和方法为临床提供药学服务,以提高治疗效果。结论临床药师根据不同情况采取针对性治疗,可取得满意效果。

不同疫情防控等级发热门诊与隔离病房医生岗位设置实践探索

新冠肺炎疫情防控背景下,首都医科大学附属北京友谊医院对发热门诊与隔离病房医生岗位设置采取全院临床科室医生支援的机制。探索科学选派方法动态调配支援医生数量是兼顾医疗质量与加快医院复工复产工作的重点。研究发现,医疗流程与院感防控等级是影响医生岗位设置的决定因素,以此构建不同防控等级下医生岗位配备方案,作为医院科学精准疫情防控理论基础的重要一环,实现了综合医院发热门诊与隔离病房安全平稳高效运转。

马桂琴教授运用小柴胡汤方证治疗颅脑术后发热的体会

小柴胡汤是和解少阳的代表方剂。其方证包括:发热,往来寒热;咳嗽咳痰,口干,口苦,咽干;胸胁苦满,默默不欲饮食;腹痛,胁下痞硬;心烦喜呕,心悸等。小柴胡汤可加减或合方用于感冒,流行性感冒,肺炎,胸膜炎,疟疾,慢性肝炎,肝硬化等其中各种原因引起的发热而见少阳证者。《伤寒论》小柴胡汤治疗的发热包括往来寒热、热入血室、数种潮热等,可发于六经中的阳明,厥阴等经,也可发于瘥后。药理研究证实小柴胡汤具有明显的退热、抗炎、调节免疫等作用。颅脑术后患者正气不足,正邪纷争,相持不下,故而反复发热。马桂琴教授运用小柴胡汤合方治疗颅脑术后发热取得良好效果。

一种基于支持向量机的论坛帖子热度回归预测算法

对论坛帖子的热度进行预测成为了当前舆情监控的一项重点研究方向,本文提出一种新的论坛帖子热度回归预测算法。在进行数据处理时,首先将帖子的影响要素进行了量化处理,研究舆情热度发展的预测。本文在进行研究时,首先做的是对论坛帖子的热度的分布特征进行研究;然后量化处理影响帖子热度的影响因子,利用以回归为基础的向量机来生成舆论的发展走向;最后,对本文的预测方法进行测试,测试结果表明本文提出的帖子热度预测算法具有良好的准确性。

补中益气汤治疗气虚发热型脾切除术后脾热疗效观察

目的:观察补中益气汤治疗气虚发热型脾切除术后脾热的临床疗效。方法:随机将符合标准的在我院普外科行脾切除术后发生脾热的49例患者分成治疗组(25例)和对照组(24例)。对照组予以术后补液、抗感染、镇痛等治疗,依据患者发热时腋温再选择物理降温、非甾体抗炎药或激素等解热治疗。基于对照组,治疗组加服补中益气汤。2组均治疗2个疗程,期间记录患者腋温数据,且比较2组患者治疗前后中医证候疗效积分。结果:经统计学处理,治疗组疗效优于对照组(P<0.05);治疗组中医气虚证候积分优于对照组,差异具有统计学意义(P<0.05)。结论:补中益气汤对缓解脾切除术后脾热有效,值得推广。

蔡炳勤教授从虚实论治腹部术后发热经验

蔡炳勤教授是全国名老中医药专家学术经验传承工作指导老师,广东省名中医,从事外科临床已逾数十载,应用中医药治疗腹部外科疾病学验俱丰,主张从虚实论治术后发热。腹部术后常出现发热,除有明确病因的发热外,多难以速愈,中医学常将其归属于内伤发热的范畴。蔡炳勤教授认为,腹部术后发热,病机复杂,变化多端,多为阴虚、血虚、气虚,或为瘀血、浊积而致,腹部术后发热当从虚实论治,恰当把握其特点,临床能化繁为简,取得良效。

当归六黄汤治疗假体周围骨折术后低热疑似感染1例

骨折术后发热是术后常见并发症,在临床中十分普遍,值得广大骨科医师的关注。骨折术后发热通常可在物理降温或应用解热镇痛药等处理后恢复至正常,但对于部分非感染性患者效果欠佳,发热持续,这种情况给予中药汤剂治疗是一个不错的方法,可减轻患者痛苦,提高临床工作效率,避免占用不必要的医疗资源。

Drug Therapeutic in the Subacute and Chronic Phase of Chikungunya Virus Infection

Background: Chikungunya fever is an infectious disease that can evolve to a subacute or chronic condition, with changes in the daily activities of patients. Drugs that aim to reduce these symptoms are used, such as corticoids (acute phase) and disease-modifying anti-rheumatic drugs (chronic phase). Objective: To evaluate the clinical response to drug therapy in the subacute and chronic phase of infection by the Chikungunya virus. Methodology: A prospective and a retrospective study with patients with subacute and chronic Chikungunya infection, out at the infection and autoimmunity outpatient clinic at the Nucleus of Tropical Medicine, from January 2016 to December 2019, in the morning of Thursdays. The patient was observed in the Baseline, first and second return, and drugs were introduced according to the stage of the disease with subsequent reassessment. The Visual Analogue Scale (VAS) was applied to all evaluation moments. Results: 101 patients were evaluated, and arthralgia was the predominant symptom in the three evaluated moments. According to the VAS, moderate baseline pain was observed in 58.1% and 58.6% of subacute and chronic cases, respectively. On the first return, moderate pain still predominated in 46.2% in subacute cases and 43% in chronic cases. In the second visit, all patients were in the chronic phase of the disease, 43.8% had VAS with no pain. Regarding the number of compromised joints in the Baseline, polyarticular involvement predominated in both subacute (79%) and chronic (74.1%) cases, in the first return, oligoarticular involvement predominated in 53.8% of subacute cases and 54.7% in chronic cases and, the second return, 40.6% of the patients had oligoarticular involvement and 43.8% had no joint involvement. As for the use of medications in the Baseline, 33.4% of subacute cases used antiinflammatory drugs, and 40% of chronic cases used corticosteroids. At the first visit, 25% of chronic patients were already using combined corticosteroids and methotrexate and 15% were using only methotrexate. In the second return, 35.1% used combined methotrexate and corticosteroids, and 64.9% used only methotrexate. Safety in the use of methotrexate was observed in the context of CHIKV treatment, as the number of adverse reactions was minimal (three patients) and the medication was well tolerated. Conclusion: It was observed that with the adjustment of the medications, there was a reduction in joint impairment, VAS showed mild pain indexes and in some cases with no pain, showing the benefit of using therapy in subacute and chronic cases and improving quality of life of these users.

城市传染病救治体系下的综合医院发热门诊设计研究

基于城市传染病救治体系,文章对综合医院的发热门诊设计展开研究,针对目前发热门诊建设存在的问题进行深入分析,尝试给出解决的思路和方法,并提出了医院发热门诊的设计指南。

物理降温在骨折术后发热患者中应用的系统研究

目的探究在骨折术后发热患者中应用物理降温的效果及物理降温的适应证。方法选择450例骨折术后发热患者，分别对影响温水擦浴物理降温效果的主要因素包括温水擦浴的水温、发热程度、发热时相进行分组研究。观察以上因素对降温效果的影响。结果水温控制在38-40℃擦浴的实验组降温有效率明显高于水温32～34℃擦浴的对照组；发热体温高峰恒定期擦浴效果明显好于体温上升期；中度热以下降温效果显著优于高热。结论单纯物理降温适用于骨折术后体温在38．5℃以下中度发热患者，感染性高热应联合药物降温。擦浴水温控制在38-40℃，擦浴时机在体温高峰期降温效果最佳。