Medicine
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Chinese rural-to-urban migrant workers (MWs) who are employed in service industry are a rapidly growing population in urban China. Like other MWs, service industry MWs (SIMWs) are generally excluded from the mainstream of city societies, but unlike other MWs, they are more marginalized in cities. Social isolation increases the feelings of loneliness; however, there are little empirical data on the epidemiology of loneliness of SIMWs. ⋯ Being aged 60 years or older (odds ratio [OR] = 2.30), marital status of "others" (OR = 2.77), being physically ill in the last 2 weeks (OR = 1.46), migrating alone (OR = 1.97), working >8 hours/day (OR = 1.06), MSPSS inside family subscale score ≤18 (OR = 1.80), and MSPSS outside family subscale score ≤38 (OR = 1.50) were significantly associated with increased risk of loneliness in SIMWs. Loneliness is prevalent in Chinese SIMWs and should be seen as a major public health issue. The high prevalence and many negative health consequences of loneliness highlight the importance of routine screening, evaluation, and treatment of loneliness in this vulnerable population.
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Propranolol, a lipophilic nonselective β-blocker, has recently been reported to be the treatment of choice for select types of infantile hemangiomas (IHs). Atenolol is a hydrophilic, selective β1-blocker and therefore may be not associated with side effects attributable to β2-adrenergic receptor blockade and lipophilicity. However, the efficacy and safety of atenolol in the treatment of IH are poorly understood. ⋯ No significant hypoglycemia, bronchospasm, bradycardia, or hypotension occurred. The most common adverse event was diarrhea, followed by agitation and sleep disturbance. This study demonstrated that atenolol was effective and safe at a dose of 1 mg/kg per day for 24 weeks in the treatment of proliferating IHs.
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Case Reports
Prolonged hemidiaphragmatic paresis following continuous interscalene brachial plexus block: A case report.
Interscalene brachial plexus block provides effective anesthesia and analgesia for shoulder surgery. One of the disadvantages of this technique is the risk of hemidiaphragmatic paresis, which can occur as a result of phrenic nerve block and can cause a decrease in the pulmonary function, limiting the use of the block in patients with reduced functional residual capacity or a preexisting pulmonary disease. ⋯ Nerve injuries associated with peripheral nerve blocks may be caused by several mechanisms. Our findings suggest that perioperative nerve injuries can occur as a result of combined mechanical and chemical injuries.
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Breast cancer patients may present with patient delay or experience provider delay-2 factors which can lead to a late-stage diagnosis and poor prognosis. Mass disasters drastically change social structures, and have the potential to contribute to these delays. However, there is little information available on patient and provider delay related to cancer after disasters. ⋯ She did not seek further medical attention for the breast symptoms for another 1 year and 10 months, despite multiple clinic visits for unrelated reasons. The present disasters, particularly the nuclear disaster, seem to have led to the social isolation of local residents, reducing their opportunities to discuss health concerns with others and seek subsequent medical attention. This case highlights that social isolation may contribute to patient and provider delay in breast cancer patients, as accentuated in this disaster setting.
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Observational Study
"Weekend effect" on stroke mortality revisited: Application of a claims-based stroke severity index in a population-based cohort study.
Previous studies have yielded inconsistent results on whether weekend admission is associated with increased mortality after stroke, partly because of differences in case mix. Claims-based studies generally lack sufficient information on disease severity and, thus, suffer from inadequate case-mix adjustment. In this study, we examined the effect of weekend admission on 30-day mortality in patients with ischemic stroke by using a claims-based stroke severity index. ⋯ This association became null after adjustment for stroke severity (OR, 1.07; 95% CI, 0.95-1.20). The "weekend effect" on stroke mortality might be attributed to higher stroke severity in weekend patients. While claims data are useful for examining stroke outcomes, adequate adjustment for stroke severity is warranted.