Therapeutics and Clinical Risk Management最新文献

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Long-Term Benefits of N-Butylphthalide in Preventing Ischemic Stroke Recurrence: A 12-Month Prospective Study. n -丁苯酞预防缺血性卒中复发的长期益处:一项12个月的前瞻性研究。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2025-05-27 eCollection Date: 2025-01-01 DOI: 10.2147/TCRM.S521562
Wei Liu, Yingzhe Shao, Jie Liu, Juan Hao, Yuting Lu, Li Yang, Jinghua Wang, Xianjia Ning
{"title":"Long-Term Benefits of N-Butylphthalide in Preventing Ischemic Stroke Recurrence: A 12-Month Prospective Study.","authors":"Wei Liu, Yingzhe Shao, Jie Liu, Juan Hao, Yuting Lu, Li Yang, Jinghua Wang, Xianjia Ning","doi":"10.2147/TCRM.S521562","DOIUrl":"10.2147/TCRM.S521562","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the effects of 12 months of NBP treatment on stroke recurrence and examined the influence of age and gender on its efficacy.</p><p><strong>Methods: </strong>A prospective cohort of 1109 patients with non-cardioembolic ischemic stroke (IS) within six months was divided into NBP (n = 538) and control (n = 571) groups. The NBP group received NBP plus standard treatment, while the control group received standard treatment alone. Primary outcomes were recurrent ischemic and hemorrhagic stroke over 12 months. Secondary outcomes included functional status (modified Rankin Scale, m-RS) and all-cause mortality.</p><p><strong>Results: </strong>NBP reduced recurrent IS by 39% compared to controls (RR:0.61,95% CI:0.40-0.93, P=0.022) and total stroke events by 39.6% (RR:0.60,95% CI:0.40-0.91,P=0.016). Protective effects were more significant in males (RR:0.52,95% CI:0.30-0.91, P=0.021 vs RR:0.53,95% CI:0.40-0.91,P=0.021) and in patients under 70 years (P<0.05). Functional outcomes (modified Rankin Scale and Barthel index) and all-cause mortality did not differ significantly between groups (all P>0.05).</p><p><strong>Conclusion: </strong>NBP significantly reduces stroke recurrence and overall vascular events, especially in males and younger patients. While it does not improve functional outcomes or mortality, NBP demonstrates substantial preventive value for recurrent strokes.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"781-792"},"PeriodicalIF":2.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Positive Collaboration in Rehabilitation Nursing Enhances Fall Efficacy and Confidence in Elderly Patients with Cerebral Infarction. 康复护理积极配合提高老年脑梗死患者跌倒疗效和信心。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2025-05-27 eCollection Date: 2025-01-01 DOI: 10.2147/TCRM.S518683
Fang Luo, Wenyao Xu, Yaqin Xu, Lingdi Lou, Chunyan Xu
{"title":"Positive Collaboration in Rehabilitation Nursing Enhances Fall Efficacy and Confidence in Elderly Patients with Cerebral Infarction.","authors":"Fang Luo, Wenyao Xu, Yaqin Xu, Lingdi Lou, Chunyan Xu","doi":"10.2147/TCRM.S518683","DOIUrl":"10.2147/TCRM.S518683","url":null,"abstract":"<p><strong>Background: </strong>Cerebral infarction is a prevalent disabling condition among the elderly, often leading to limb dysfunction and psychological challenges that significantly impair quality of life. Traditional nursing approaches have primarily focused on physical rehabilitation; however, growing evidence highlights the importance of psychological factors-such as emotional well-being and rehabilitation confidence-in influencing recovery outcomes. Positive collaboration in rehabilitation nursing, which involves coordinated efforts among patients, healthcare providers, and family members, has emerged as a holistic approach to enhance both physical and psychological recovery.</p><p><strong>Objective: </strong>To analyze the effects of positive collaboration concept rehabilitation nursing on elderly patients with cerebral infarction, focusing on fall efficacy and rehabilitation confidence.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on clinical data from 106 elderly patients with cerebral infarction, admitted from October 2022 to April 2024. Patients were divided into a control group (n=53, receiving routine care) and an observation group (n=53, receiving positive collaboration rehabilitation nursing). Neurological function (NIHSS), negative emotions (SAS, SDS), fall efficacy (MFES), activities of daily living (ADL), quality of life (SS-QOL), rehabilitation confidence (CaSM), and nursing satisfaction (NSNS) were compared between the two groups.</p><p><strong>Results: </strong>The observation group showed significantly lower NIHSS scores at 2 weeks and 1 month post-intervention (P<0.05). Both groups demonstrated reduced SAS and SDS scores, with the observation group showing greater improvement (P<0.05). A higher proportion of patients in the observation group (56.60%) showed excellent fall efficacy compared to the control group (37.74%) (P<0.05). The observation group also had greater improvements in ADL, SS-QOL, and rehabilitation confidence, with higher patient satisfaction (90.57% vs 71.70%, P<0.05).</p><p><strong>Conclusion: </strong>Positive collaboration rehabilitation nursing significantly improves neurological function, emotional well-being, fall efficacy, and quality of life in elderly patients with cerebral infarction. This approach increases patient and family satisfaction, highlighting the potential benefits of integrating collaborative care into clinical practice.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"793-805"},"PeriodicalIF":2.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Role of Integrated Nursing Interventions in Traumatic Brain Injury Management in the Emergency Department: A Retrospective Study. 综合护理干预在急诊科创伤性脑损伤管理中的作用:回顾性研究。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2025-05-26 eCollection Date: 2025-01-01 DOI: 10.2147/TCRM.S512673
Yanli Zhou, Linxia Zhou, Xianxiang Chen
{"title":"The Role of Integrated Nursing Interventions in Traumatic Brain Injury Management in the Emergency Department: A Retrospective Study.","authors":"Yanli Zhou, Linxia Zhou, Xianxiang Chen","doi":"10.2147/TCRM.S512673","DOIUrl":"10.2147/TCRM.S512673","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a leading cause of both disability and death, frequently necessitating treatment in emergency departments (ED). Integrated nursing interventions are critical in the management of TBI patients, but limited research has been conducted to evaluate their effectiveness in this setting. The aim of this article is to investigate and evaluate the impact of integrated nursing interventions on the management of TBI patients in the ED.</p><p><strong>Method: </strong>A retrospective study was conducted among 216 patients with TBI who came to the ED between January 2022 and December 2022, of whom 120 were treated with nursing interventions and 96 were not treated with nursing interventions. The integrated interventions included rapid triage, continuous monitoring of neurological status, early rehabilitation involvement, patient and family education, and interdisciplinary care coordination. The medical records were reviewed to assess the utilization of nursing interventions and analyze the impact of these interventions on the short-term and long-term prognosis of TBI patients. Patient demographics, clinical characteristics, and outcomes were analyzed using descriptive statistics and logistic regression analysis.</p><p><strong>Result: </strong>Among the 216 TBI patients, 96 (44.4%) received nursing interventions as part of their ED care. These patients had significantly lower rates of adverse events such as intracranial hemorrhage (3.3% vs 12.5%, P=0.018) and hospital stays (7 ± 2 days vs 10 ± 4 days, P<0.001). Logistic regression analysis showed that nursing interventions were significantly associated with a decreased risk of adverse events (OR=0.25, 95% CI=0.10-0.63, P=0.003).</p><p><strong>Conclusion: </strong>Integrated nursing interventions are essential in the care of TBI patients in the emergency department. Early detection, swift treatment, continuous monitoring, assessment, and education for both patients and their families can enhance recovery and minimize the likelihood of complications. Implementation of nursing interventions should be encouraged in EDs to improve the quality of TBI care. Further studies are needed to investigate the optimal strategies and cost-effectiveness of nursing interventions in TBI management in the ED.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"769-780"},"PeriodicalIF":2.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative Sedative Effects of Esketamine and Dexmedetomidine Versus Dexmedetomidine Alone in Patients Undergoing Spinal Tumor Surgery. 艾氯胺酮联合右美托咪定与单用右美托咪定在脊柱肿瘤手术中的镇静效果比较。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2025-05-23 eCollection Date: 2025-01-01 DOI: 10.2147/TCRM.S515869
Chuanyan Lin, Liyong Yuan, Jun Shi, Lingsi Kong, Ni Luo, Jianlin Wang
{"title":"Comparative Sedative Effects of Esketamine and Dexmedetomidine Versus Dexmedetomidine Alone in Patients Undergoing Spinal Tumor Surgery.","authors":"Chuanyan Lin, Liyong Yuan, Jun Shi, Lingsi Kong, Ni Luo, Jianlin Wang","doi":"10.2147/TCRM.S515869","DOIUrl":"10.2147/TCRM.S515869","url":null,"abstract":"<p><strong>Objective: </strong>Esketamine and dexmedetomidine are commonly used sedatives in surgery, which can result in minimal respiratory depression and analgesic activity. This study investigated the sedative effect of esketamine combined with dexmedetomidine on patients undergoing spinal tumor (ST) surgery.</p><p><strong>Methods: </strong>We did a retrospective analysis at the Anesthesiology Department of Ningbo City's the sixth Hospital. They studied 75 ST surgery patients who got esketamine in combination with dexmedetomidine (Group ED) between April 2022 and June 2024. In a 1:1 cohort, compare these individuals to those who only received dexmedetomidine at the same time period (Group D). The primary outcome is perioperative hemodynamic status. The secondary outcomes were pain intensity, intraoperative neurophysiological monitoring (IONM), and the occurrence of adverse responses.</p><p><strong>Results: </strong>Compared with group E, the group ED had lower mean arterial pressure (MAP), heart rate (HR), and visual-analogue scale (VAS) scores after the start of surgery (all P<0.05). There was no significant difference in the waiting time for perioperative motor evoked potential (MEP) and the intensity of the first induced MEP current between the two groups (all P>0.05); The Group ED first induced MEP amplitude, somatosensory evoked potential (SEP) amplitude, and MEP amplitude greater than the Group D, while SEP latency and MEP latency were smaller than the Group D (all P<0.05). There was no significant difference in the incidence of perioperative adverse events between the two groups (P>0.05).</p><p><strong>Conclusion: </strong>Compared with dexmedetomidine alone, the combination of esketamine and dexmedetomidine during ST surgery can demonstrated superior sedation and pain control without increasing adverse event risk, making it a viable alternative for ST surgery anesthesia.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"747-755"},"PeriodicalIF":2.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative Outcomes of Apical Induction Versus Pulp Revascularization in Young Permanent Anterior Teeth with Traumatic Pulp Necrosis. 创伤性牙髓坏死年轻恒前牙的根尖诱导与牙髓血运重建术疗效比较。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2025-05-21 eCollection Date: 2025-01-01 DOI: 10.2147/TCRM.S522358
Gang Cheng, Xiuyin Wu, Wenbo Li, Zhijun Lv
{"title":"Comparative Outcomes of Apical Induction Versus Pulp Revascularization in Young Permanent Anterior Teeth with Traumatic Pulp Necrosis.","authors":"Gang Cheng, Xiuyin Wu, Wenbo Li, Zhijun Lv","doi":"10.2147/TCRM.S522358","DOIUrl":"10.2147/TCRM.S522358","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate and analyze the clinical application of pulp revascularization surgery in young permanent anterior teeth with pulp necrosis caused by trauma.</p><p><strong>Methods: </strong>This study selected 40 cases of young permanent anterior teeth with pulp necrosis caused by trauma, treated at our hospital between August 2018 and December 2022. All patients met the complete inclusion criteria and were divided into a study group and a control group based on treatment methods. The study group received pulp revascularization surgery, and the control group received apical induction surgery. There were 20 patients in each group. Comparative observation indicators included clinical treatment outcomes, clinical-related indicators, pain levels, and patient family satisfaction.</p><p><strong>Results: </strong>The treatment outcomes in the study group were significantly better than those in the control group (P < 0.05). The crown-to-root ratio in the study group was lower than that in the control group, and the root canal wall thickness was higher in the study group, with all P < 0.05. The pain level grading in the study group was significantly lower than that in the control group (P < 0.05). Satisfaction indicators for both patients and their families were significantly higher in the study group compared to the control group, with all P < 0.05.</p><p><strong>Conclusion: </strong>Pulp revascularization surgery shows great potential in the clinical application for young permanent anterior teeth with pulp necrosis caused by trauma. It can effectively improve the treatment outcomes, clinical indicators, and alleviate pain, while significantly enhancing patient satisfaction. With continuous research and practice, this advanced treatment method is expected to provide a better oral health experience for patients and promote the development of the dental field.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"737-745"},"PeriodicalIF":2.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship Between Timing of PCSK9 Inhibitor Monoclonal Antibody Initiation and Clinical Outcomes in Patients with Prior Cardiovascular Events. 既往心血管事件患者PCSK9抑制剂单克隆抗体起始时间与临床结局的关系
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2025-05-21 eCollection Date: 2025-01-01 DOI: 10.2147/TCRM.S512708
Eduard Sidelnikov, Bethany A Kalich, Margot Lisa Miglins, Jasjit K Multani, Rifat Tuly, Kevin Hawkins, Usman Baber
{"title":"Relationship Between Timing of PCSK9 Inhibitor Monoclonal Antibody Initiation and Clinical Outcomes in Patients with Prior Cardiovascular Events.","authors":"Eduard Sidelnikov, Bethany A Kalich, Margot Lisa Miglins, Jasjit K Multani, Rifat Tuly, Kevin Hawkins, Usman Baber","doi":"10.2147/TCRM.S512708","DOIUrl":"10.2147/TCRM.S512708","url":null,"abstract":"<p><strong>Purpose: </strong>Timing of initiation of proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i) monoclonal antibody (mAb) therapy and its impact on cardiovascular outcomes is unknown. The aim was to identify any association between timing of PCSK9i mAb initiation after a major adverse cardiovascular event (MACE) and the rate of subsequent MACE.</p><p><strong>Patient and methods: </strong>A retrospective cohort study of adult patients in the United States with a MACE (myocardial infarction, stroke, unstable angina, or coronary revascularization) from January 1, 2017 to February 28, 2022 was conducted using administrative claims databases (index date = first observed MACE during this period). Patients were required to have ≥360 days of data visibility prior to (baseline period) and for ≥30 days after the index date (minimum, variable follow up period), and ≥1 prescription claim for PCSK9i mAb therapy on or after the index date. Subsequent MACE rates, time from index MACE to PCSK9i mAb initiation, and time to subsequent MACE were reported.</p><p><strong>Results: </strong>A total of 58,997 patients with ≥1 MACE were identified (mean age = 64 years; 58% male; median follow up=1,241 days). Over half of the patients did not initiate a PCSK9i mAb in the first year after the index MACE. Overall, 35% (n = 20,465) had ≥1 subsequent MACE. Compared to the period between index MACE and prior to PCSK9i mAb initiation, rates of subsequent MACE after PCSK9i mAb initiation were reduced in a time-dependent manner by 70% among patients who initiated PCSK9i mAb therapy within 30 days, 78% (31-90 days), 76% (91-180 days), 65% (181-360 days), and 42% (>360 days) after the index MACE. Those who initiated PCSK9i mAb within 30 days of the index MACE had longer median time to the first subsequent MACE (111 days) compared to patients who initiated at later times.</p><p><strong>Conclusion: </strong>This study provides evidence that earlier initiation of PCSK9i mAb therapy after a MACE appeared to be associated with longer time to a subsequent MACE. Patients without timely treatment are left at an unnecessarily elevated risk of further MACE.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"727-736"},"PeriodicalIF":2.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Elevated MPV: A Key Indicator of Acute Anterior Circulation Stroke Prognosis in Mechanical Thrombectomy. 机械取栓术中MPV升高:急性前循环卒中预后的关键指标。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2025-05-19 eCollection Date: 2025-01-01 DOI: 10.2147/TCRM.S522253
Shi-Yuan Tian, Min-Jie Yu, Kefu Mei, Bing Xu, Lian-Chen Xiao, Hong-Bin Wen, Fu-Rong Shang
{"title":"Elevated MPV: A Key Indicator of Acute Anterior Circulation Stroke Prognosis in Mechanical Thrombectomy.","authors":"Shi-Yuan Tian, Min-Jie Yu, Kefu Mei, Bing Xu, Lian-Chen Xiao, Hong-Bin Wen, Fu-Rong Shang","doi":"10.2147/TCRM.S522253","DOIUrl":"10.2147/TCRM.S522253","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to investigate the relationship between admission platelet indices and 90-day clinical outcomes in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 247 AIS patients with anterior circulation large vessel occlusion (LVO) treated with MT between July 2021 and April 2024. Platelet indices (PIs) were measured at admission. Participants were stratified into two groups based on 90-day modified Rankin Scale (mRS) outcomes. Multivariate regression analysis and receiver operating characteristic (ROC) curves were employed to evaluate relationships between admission platelet indices, clinical parameters, and functional outcomes.</p><p><strong>Results: </strong>Among 247 enrolled patients, those with unfavorable outcomes (mRS 3-6) exhibited significantly higher platelet distribution width (PDW) and Mean Platelet Volume (MPV) levels compared to the favorable outcome group (mRS 0-2). Elevated MPV remained an independent predictor of unfavorable outcomes after multivariate adjustment (OR=2.747, 95% CI: 1.791-4.216, <i>P</i><0.001). ROC analysis identified a MPV threshold >10.75 fL for predicting unfavorable prognosis, demonstrating 55.4% sensitivity and 81.2% specificity.</p><p><strong>Conclusion: </strong>PDW is associated with unfavorable 90-day outcomes in patients with acute anterior circulation LVO following MT, while elevated MPV may serve as a prognostic indicator for unfavorable functional outcomes in patients with acute anterior circulation LVO following MT.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"715-725"},"PeriodicalIF":2.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corticosteroid Therapy for Diffuse Alveolar Hemorrhage with Respiratory Failure in Hematologic Malignancies: A Retrospective Cohort Study. 恶性血液肿瘤弥漫性肺泡出血合并呼吸衰竭的皮质类固醇治疗:一项回顾性队列研究。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2025-05-17 eCollection Date: 2025-01-01 DOI: 10.2147/TCRM.S520299
Jee Hwan Ahn, Kyung Mee Song, Jin Won Huh, Jung-Hee Lee, Sang-Bum Hong, Je-Hwan Lee, Chae-Man Lim, Kyoo-Hyung Lee, Younsuck Koh
{"title":"Corticosteroid Therapy for Diffuse Alveolar Hemorrhage with Respiratory Failure in Hematologic Malignancies: A Retrospective Cohort Study.","authors":"Jee Hwan Ahn, Kyung Mee Song, Jin Won Huh, Jung-Hee Lee, Sang-Bum Hong, Je-Hwan Lee, Chae-Man Lim, Kyoo-Hyung Lee, Younsuck Koh","doi":"10.2147/TCRM.S520299","DOIUrl":"10.2147/TCRM.S520299","url":null,"abstract":"<p><strong>Background: </strong>Although DAH in hematopoietic stem cell transplantation recipients is commonly treated with systemic corticosteroids, the efficacy of steroid therapy on DAH with respiratory failure in hematologic malignancy patients has not been studied. We aimed to investigate the effectiveness of steroid therapy in hematologic malignancy patients who developed DAH with respiratory failure and required treatment in the intensive care unit (ICU).</p><p><strong>Methods: </strong>Among DAH patients with leukemia, lymphoma, or multiple myeloma, those who were not admitted to the ICU were excluded. Included patients were classified into the steroid or control group according to steroid therapy. Patient data were retrospectively collected from electrical medical records. The primary outcome was ICU mortality.</p><p><strong>Results: </strong>A total of 44 patients (steroid group, n = 32; control group, n = 12) were included. At the DAH diagnosis, the steroid group was less likely to have a history of previously treated solid malignancy (3% vs 25%; <i>P</i> = 0.025) compared to the control group. ICU mortality in the steroid group was not significantly different from that in the control group (66% vs 67%; <i>P</i> = 0.948). Only in the steroid group, the ratio of arterial oxygen partial pressure to fractional inspired oxygen was significantly improved after 2 days from the DAH diagnosis (151 ± 64 vs 120 ± 38 mm Hg; <i>P</i> = 0.039).</p><p><strong>Conclusion: </strong>Hematologic malignancy patients who developed DAH with respiratory failure and were admitted to the ICU had high mortality, irrespective of steroid therapy.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"705-714"},"PeriodicalIF":2.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Circulating-Water Mattress Enhances Thermal Comfort and Patient Satisfaction but Shows Non-Superiority in Temperature Maintenance in Ophthalmic Day-Case Surgery: A Randomized Controlled Trial. 循环水床垫提高热舒适性和患者满意度,但在眼科日间手术的温度维持方面没有优势:一项随机对照试验。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2025-05-15 eCollection Date: 2025-01-01 DOI: 10.2147/TCRM.S514218
Yanhong Yan, Jiao Geng, Chunhua Xi, Xu Cui, Guyan Wang
{"title":"Circulating-Water Mattress Enhances Thermal Comfort and Patient Satisfaction but Shows Non-Superiority in Temperature Maintenance in Ophthalmic Day-Case Surgery: A Randomized Controlled Trial.","authors":"Yanhong Yan, Jiao Geng, Chunhua Xi, Xu Cui, Guyan Wang","doi":"10.2147/TCRM.S514218","DOIUrl":"10.2147/TCRM.S514218","url":null,"abstract":"<p><strong>Purpose: </strong>Perioperative hypothermia, a common complication of general anesthesia, is associated with adverse outcomes. While active warming methods are recommended, the effectiveness of circulating-water mattresses during ophthalmic surgeries remains understudied. This randomized controlled trial assessed whether a circulating-water mattress combined with a cotton quilt (Group W) was superior to a cotton quilt alone (Group C) in maintaining patient body temperature during ophthalmic day-case surgery.</p><p><strong>Patients and methods: </strong>Group W patients (n=39) used a preheated circulating-water mattress (38°C) on the operating table and were covered with a cotton quilt (from their entry to the operating room until they returned to the ward). Group C patients (n=38) lay on an unheated table and were covered with a cotton quilt. The axillary temperature in the surgical waiting area served as the baseline. Axillary temperature, ambient temperature, heart rate, and mean arterial pressure were documented at anesthesia induction (T<sub>0</sub>), start of surgery (T<sub>1</sub>), every 5 min for the first hour (T<sub>2</sub>-T<sub>13</sub>), and end of surgery (T<sub>14</sub>). Satisfaction and thermal comfort scores were assessed at baseline in the waiting area, 5 min before anesthesia induction (t<sub>0</sub>), 15 min after entering the post-anesthesia care unit (PACU) (t<sub>1</sub>), and upon leaving the PACU (t<sub>2</sub>). The primary outcome measure was the axillary temperature at T<sub>14</sub>.</p><p><strong>Results: </strong>At T<sub>14</sub>, Group W had a higher axillary temperature than Group C (36.40±0.06°C vs 36.18±0.06°C, <i>P</i>=0.011), with the mean difference 0.22°C, which did not exceed the predefined superiority threshold of 0.30°C, indicating that the warming effect in Group W was not superior to that in Group C. However, thermal comfort and satisfaction scores were significantly enhanced at t<sub>0</sub> and t<sub>1</sub> (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>During ophthalmic day-case surgeries, a circulating-water mattress plus a cotton quilt was not superior, regarding their warming effect, but they significantly enhanced patients' thermal comfort and satisfaction.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"669-680"},"PeriodicalIF":2.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inflammatory Burden Index Associated with Recurrence of Atrial Fibrillation After Radiofrequency Catheter Ablation. 射频导管消融后心房颤动复发与炎症负担指数相关。
IF 2.8 3区 医学
Therapeutics and Clinical Risk Management Pub Date : 2025-05-15 eCollection Date: 2025-01-01 DOI: 10.2147/TCRM.S518620
Siliang Peng, Feng Li, Mengchao Jin, You Zhang, Hui Li, Jiayu Yin
{"title":"Inflammatory Burden Index Associated with Recurrence of Atrial Fibrillation After Radiofrequency Catheter Ablation.","authors":"Siliang Peng, Feng Li, Mengchao Jin, You Zhang, Hui Li, Jiayu Yin","doi":"10.2147/TCRM.S518620","DOIUrl":"10.2147/TCRM.S518620","url":null,"abstract":"<p><strong>Background: </strong>Recurrence rates of atrial fibrillation (AF) remain high after radiofrequency catheter ablation (RFCA), and inflammation plays an important role in the process. Inflammatory burden index (IBI) as a new inflammatory marker has been found to be associated with worse prognosis in cardiovascular disease. But there are no studies on its role in predicting AF recurrence. The aim of this study was to assess the value of IBI in predicting recurrence of AF after RFCA.</p><p><strong>Methods: </strong>This was a single-center retrospective observational study. Consecutive enrolment of PersAF who underwent first-time radiofrequency ablation between January 2021 and June 2024. Inflammatory Burden Index (IBI) was calculated as C-reactive protein (CRP) × neutrophil/lymphocyte (NLR).</p><p><strong>Results: </strong>A total of 142 (27.2%) patients experienced recurrence after RFCA. Multivariate analysis showed that PersAF (OR = 1.599; 95% CI: 1.028 ~ 2.486, p = 0.018), CHA<sub>2</sub>DS<sub>2</sub>-VASc score≥2 (OR = 1.769; 95% CI: 1.142 ~ 2.741, p = 0.011), LAD (OR = 1.098; 95% CI: 1.054 ~ 1.145, p < 0.001) and IBI (OR = 1.028; 95% CI: 1.007 ~ 1.050, p = 0.009), were independent predictors of recurrence. ROC analysis shows superiority of IBI (AUC=0.695, 95% CI: 0.647 ~ 0.743, p < 0.001) over CRP and NLR in predicting AF recurrence. When IBI was integrated into the traditional model (including PersAF, LAD and CHA<sub>2</sub>DS<sub>2</sub>-VASc Score), the discrimination and reclassification accuracy for the recurrence were significantly improved.</p><p><strong>Conclusion: </strong>Inflammatory load index associated with the recurrence of AF after RFCA. Integration of IBI can improve the model about the recurrence of AF after RFCA.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"681-689"},"PeriodicalIF":2.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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