Medicina
-
Post-stroke depression (PSD) is the most common mental health problem after a stroke with an incidence of up to 33%. PSD has a negative impact on the rehabilitation and recovery of motor and cognitive dysfunction after a stroke and significantly increases the chance of the recurrence of neurovascular events. At present, medication is the preferred method of coping with PSD. ⋯ In recent years, as the advantages of traditional Chinese medicine (TCM) in clinical treatment continue to emerge, Chinese herbal and TCM formulae have begun to enter the awareness of Chinese scholars and even scholars around the world. As a classic formula with a history of more than 400 years, Chaihu Shugan powder (CHSG) has great advantages in the clinical treatment of PSD. Based on existing clinical and experimental studies, this article comprehensively analyzes clinical cases, mechanisms of action, and drug and chemical effects of CHSG in the treatment of PSD in order to provide more clinical experience and experimental theoretical support for CHSG in the treatment of PSD.
-
Background and Objectives: People with Alzheimer's disease and dementia in general benefit from home-based care as demonstrated via their better quality of life, increased lifespan, and delayed disease progression. Since currently nearly half of the dementia care is being provided by informal and unpaid caregiving, the health, wellbeing and quality of life of informal dementia caregivers is extremely important. Materials and Methods: We used a systematic review process with searches based upon the six elements from the "Quality of Life Scale for Informal Carers of Older Adults" with additional items on traditional and non-traditional caregiving ideologies, as well as caregivers' experiences. ⋯ Informal caregivers of older adults with Alzheimer's Disease experience significant emotional strain, documented through increased levels of anxiety and depression, as well as increased caregiver burden and poorer quality of life, primarily due to caregiving ideologies, financial strain and a lack of support. Conclusions: Our findings suggest that caregiving should be a normative component of adult education to better prepare individuals with the mental and physical skills required for undertaking informal caregiving. They should also help inform policy makers to develop novel programs and services to both assist and reduce informal caregivers' strain, whilst considering their different social and cultural contexts.
-
Multicenter Study
Efficacy of Tocilizumab in Management of COVID-19 Patients Admitted to Intensive Care Units: A Multicenter Retrospective Cohort Study.
Background and Objectives: Mortality and illness due to COVID-19 have been linked to a condition known as cytokine release syndrome (CRS) that is characterized by excessive production of inflammatory cytokines, particularly interleukin-6 (IL-6). Tocilizumab (TCZ), a recent IL-6 antagonist, has been redeployed as adjunctive treatment for CRS remission in COVID-19 patients. This study aimed to determine the efficacy of Tocilizumab on patients' survival and the length of stay in hospitalized COVID-19 patients admitted to the intensive care unit. ⋯ Results: A total of 740 patient data records were included in the analysis, where 630 patients followed the routine COVID-19 protocol, while 110 patients received TCZ, need to different respiratory support after hospitalization, and inflammatory mediators such as C-reactive protein (CRP), ferritin, and Lactate dehydrogenase (LDH) showed a statistically significant difference between the TCZ group and the control group. Regarding the primary outcome (discharged alive or death) and neither the secondary outcome (length of hospital stay), there is no statistically significant difference between patients treated with TCZ and the control group. Conclusions: Our cohort of patients with moderate to severe COVID-19 did not assert a reduction in the risk of mortality or the length of stay (LOS) after TCZ administration.
-
Background and Objectives: An increasing number of studies have shown the influence of primary tumor location of colon cancer on prognosis, but the prognostic difference between colon cancers at different locations remains controversial. After comparing the prognostic differences between left-sided and right-sided colon cancer, the study subdivided left-sided and right-sided colon cancer into three parts, respectively, and explored which parts had the most significant prognostic differences, with the aim to further analyze the prognostic significance of primary locations of colon cancer. Materials and Methods: Clinicopathological data of patients with colon cancer who underwent radical surgery from the Surveillance, Epidemiology, and End Results Program database were analyzed. ⋯ After propensity score matching, multivariate analyses showed that cecum cancer was an independent unfavorable factor for cancer specific survival (HR [95% CI]: 1.11 [1.04−1.17], p = 0.001 for 2004−2009; HR [95% CI]: 1.23 [1.13−1.33], p < 0.001 for 2010−2015) and overall survival (HR [95% CI]: 1.09 [1.04−1.14], p < 0.001 for 2004−2009; HR [95% CI]: 1.09 [1.04−1.14], p < 0.001 for 2010−2015) compared to sigmoid colon cancer. Conclusions: The study indicates the prognosis of cecum cancer is worse than that of sigmoid colon. The current dichotomy model (right-sided vs. left-sided colon) may be inappropriate for the study of colon cancer.
-
Background and Objectives: Pain during and after the procedure remains the leading concern among women undergoing cesarean section. Numerous studies have concluded that the type of anesthesia used during a cesarean section undoubtedly affects the intensity and experience of pain after the operation. Materials and Methods: This prospective cohort study was conducted at the Clinic for Gynecology and Obstetrics, Clinical Center "Dragisa Misovic-Dedinje", Belgrade, Serbia. ⋯ On pain attribute scale intensity, GEA had significantly higher postoperative pain levels within all intervals. Patients who received RA had a shorter time to first oral food intake, first independent mobilization, and faster lactation onset in contrast to GEA. Conclusions: The application of RA presented superior postoperative pain relief, resulting in earlier mobilization, shorter time to first oral food intake, and faster lactation onset in contrast to GEA.