Brit J Hosp Med
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Aims/Background Ischemic stroke (IS), a cerebrovascular condition, is commonly detected by evaluating carotid intima-media (CIA) stenosis. Symptomatic CIA stenosis carries a high risk (up to 32%) of another ischemic event within 12 weeks, while asymptomatic CIA stenosis has an annual risk ranging from 1% to 2%. Therefore, this study aims to explore the diagnostic value of clinical features and carotid plaque characteristics in both symptomatic and asymptomatic IS. ⋯ The results of the multivariate logistics regression analysis showed that plaque vulnerability, CHD, and plaque hypoechogenicity were independent predictors of symptomatic stroke. The clinical-ultrasonographic prediction model showed an area under the curve (AUC) of 0.85 [95% confidence interval (CI): 0.82-0.88], a sensitivity of 0.74 (95% CI: 0.69-0.78), and a specificity of 0.81 (95% CI: 0.76-0.87), with a good performance in the model prediction. Conclusion Plaque vulnerability, CHD, and plaque hypoechogenicity are meaningful predictors of symptomatic ischemic stroke and deserve attention in the future.
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Workplace-based assessments (WPBAs) in postgraduate training may not always provide an accurate representation of a trainee's capability to perform a given task, or a true measure of a trainee's overall competence in clinical practice settings. This article describes how trainers can use a theory-driven and evidence-based intervention called dynamic assessment for providing an individual with the best opportunity to demonstrate a more accurate representation of their performance, and ultimately present the best version of themselves when undergoing an observed WPBA, such as a Direct Observation of Procedural Skills (DOPS) or Mini Consultation Evaluation Exercise (MiniCEX). Dynamic assessment simultaneously combines educational support with assessment as the trainee undergoes the WPBA by using focussed questions as prompts to facilitate an individual trainee's essential coordination of their motivational and thinking processes since this is often challenged during assessments. In addition, the response to the prompts can also provide trainers with information to inform specific feedback for future professional development.
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Comparative Study
Comparative Study of Safety and Efficacy of α-n-Butyl-2-cyanoacrylate Glue versus Traditional Embolization Materials in the Treatment of Acute Renal Hemorrhage.
Aims/Background This study aims to evaluate the safety and efficacy of α-n-butyl-2-cyanoacrylate (NBCA) glue in comparison with traditional embolization materials for the treatment of acute renal hemorrhage. Methods A total of 105 patients with the acute renal hemorrhage who underwent superselective renal artery embolization were enrolled. The patients were divided into two groups based on the embolization materials used: the traditional group (43 cases, control group) and the medical glue group (62 cases, observation group). ⋯ The degree of vascular embolization also influenced the extent of postoperative inflammatory response and renal function damage in patients with acute renal hemorrhage. Conclusion Compared to traditional embolization materials, NBCA glue demonstrates a clear hemostatic effect in the treatment of patients with acute renal hemorrhage, while also leading to reduced postoperative inflammatory response and renal function damage. NBCA adhesive is both safe and effective for treating acute renal hemorrhage.
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Comparative Study
Effectiveness and Safety of Gabapentin versus Pregabalin in the Treatment of Postherpetic Neuralgia: A Retrospective Cohort Study.
Aims/Background Postherpetic neuralgia (PHN) is a common chronic pain disease that persists after the rash (clusters of clear blisters on the surface of the skin) has healed, adversely affecting the quality of life of affected patients. Gabapentin (GPT) and pregabalin (PGB) are two commonly used drugs for the treatment of PHN, but there have been broad concerns regarding their efficacy and safety. Thus, this retrospective cohort study was conducted to investigate the effectiveness and safety of GPT versus PGB in the treatment of PHN. ⋯ In addition, significantly lower VAS, SQS, PSQI, SAS, and SDS scores were observed in the observation group after treatment, compared with the control group (p < 0.05). The observation group showed evidently shorter time to pain relief than the other group (p < 0.05). Conclusion PGB is an effective and safe medication for the treatment of PHN, by improving the analgesic effect and sleep quality, and alleviating negative emotions.
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Aims/Background The prevalence of postpartum fatigue among primipara is high in China, which seriously affects women's subsequent physical and mental recovery. In order to deeply understand this phenomenon, domestic scholars began to conduct research on postpartum fatigue from the aspects of assessment tools and intervention measures. This study aims to investigate postpartum fatigue in primiparous women and its association with family functioning and social support, providing valuable insights for improving the condition in this population. ⋯ Poor newborn health, artificial feeding, and nighttime feeding frequency ≥4 times per night can exacerbate postpartum fatigue. Good social support and role adaptation are beneficial in alleviating postpartum fatigue. Strengthening social support and role adaptation can help reduce postpartum fatigue levels in primiparous women.