Medicine
-
The aim was to study the independent risk factors of internal fixation failure in proximal femoral anti-rotation intramedullary nailing for intertrochanteric femur fracture, and to build a nomogram prediction model accordingly. Clinical data of patients with intertrochanteric femoral rotor fractures admitted to the First People's Hospital of Longquanyi District from January 2018 to January 2023 were retrospectively collected. The occurrence of spiral blade cut out, internal fixation breakage, peri-internal fixation fracture, hip internal rotation deformity, and fracture nonunion within 1 year after surgery were included in the internal fixation failure group, and the rest were included in the internal fixation success group. ⋯ Ultimately, 374 patients with intertrochanteric fractures were included in the study, and 57 patients were included in the internal fixation failure group, with an internal fixation failure rate of 15.24%. After univariate and multivariate logistic regression analyses, a total of 5 factors were identified as independent risk factors for internal fixation failure after intertrochanteric femur fracture surgery: unstable fracture, comorbid underlying disease, severe osteoporosis, a cusp distance of >30 mm, and poor quality of fracture reduction. Postoperative internal fixation failure of intertrochanteric fractures of femur is affected by multiple factors, and clinically orthopedic surgeons should formulate reasonable and effective solutions for high-risk patients in order to protect the surgical effect and improve the success rate of surgery.
-
Health services institutes worldwide are trying to reduce defensive medical practice to limit its negative impact on patient care. We evaluated the factors associated with this defensive medical practice among medical professionals in the United Arab Emirates. This study deployed multivariate logistic regression analysis. ⋯ The second most common defensive practice was calling inpatient admission, delaying discharge, additional testing, etc without medical indication and solely on patient or family request (265, 47.1%); the factors associated were age (aOR 0.46, 95% CI 0.33-0.64, P = .001), private sector (aOR 0.66, 95% CI 0.53-0.83, P = .001), and support by workplace staff (aOR 0.50, 95% CI 0.34-0.73, P = .001). Other defensive practices included refraining from difficult procedures or referring cases to another colleague due to the fear of complications (166, 29.5%) and unwillingness to accept patients in case of previous litigation history (157, 28.1%). This multivariable analysis in the United Arab Emirates found that higher age, higher job grades, indemnity cover and support by workplace staff reduced the odds of defensive medicine practice while working in the private sector had a mixed effect.
-
Case Reports
The combination of Qing Kailing injection and clindamycin injection leads to systemic adverse reactions: Case report.
It is imperative to be cautious about the potential systemic allergic reaction caused by the combined use of Qing Kailing Injection (QKI) and clindamycin as it may be life-threatening. ⋯ Caution should be exercised in the concurrent use of traditional Chinese medicine injections and antibacterial drugs in clinical treatment because of the potential for allergic reactions to both medications. If combination therapy is deemed necessary, adequate flushing of the infusion pipe with saline or replacement with a new infusion device is recommended, while closely monitoring the patient for any signs of allergic reactions.
-
Observational Study
Liver disease-linked metabolic and behavioral factors associated with cognitive performance in an observational study of community dwelling adults.
Modifiable risk factors associated with cognitive functioning are important for identifying potential targets for intervention development. Although there are a few recognized modifiable risk factors (e.g., diabetes mellitus, diet, physical activity), there are limitations in the conclusions that can be drawn due to limited data. Therefore, this study examined the relationship between modifiable liver disease-linked metabolic and behavioral factors in a sample of community dwelling adults who do not currently experience functional limitations due to cognitive abilities. ⋯ The modifiable factors that were most consistently related to cognitive performance were waist-to-height ratio, which was related to a decrease in performance in 4 of the domains (short-term and long-term visual memory, working memory, and abstract reasoning), and the presence of nonalcoholic fatty liver disease, which was related to an increase in performance in the same 4 domains. This study suggests that liver disease-linked modifiable factors are associated with cognitive performance, even in middle-aged individuals without self-reported cognitive dysfunction. Further research is needed to explore the mechanisms that impact cognitive performance in relation to these factors to establish early intervention targets for reducing future cognitive deficits.
-
Investigations have indicated that there is a correlation between thyroid nodules and patients'negative emotions. Nevertheless, the risk factors contributing to the development of negative emotions in thyroid nodule patients remain unidentified. This cross-sectional study recruited 150 patients diagnosed with thyroid nodules through ultrasound examination from January 2022 to January 2023 at Jinan Central Hospital, the Second Affiliated Hospital of Shandong First Medical University, and Qingyun County Maternal and Child Health Hospital as the case group, which were categorized based on their levels of anxiety and depression. ⋯ The results of the binary logistic regression analysis revealed that both fatigue state (P = .013) and negative life events (P = .001) exerted independent effects on anxiety, whereas negative life events (P = .002) had independent effects on depression. This study enhances the understanding of the relationship between thyroid nodules and anxiety and depression. It reveals that thyroid nodules are associated with negative emotions and that negative life events have a significant influence on anxiety and depression in these individuals, which may contribute to the development of strategies for preventing and treating thyroid nodules in clinical practice.