Annals of palliative medicine
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The outbreak of coronavirus disease 2019 (COVID-19) has increased the risk of infection among medical staff. Anesthetists may have direct or indirect contact with COVID-19 patients' saliva droplets, blood, and other secretions in their daily work. If infection-prevention measures are not appropriate, it will not only cause individual medical staff infection, but also cross-infection among patients and other medical staff. ⋯ We also discuss the implementation of anesthesia, including anesthesia types, induction of general anesthesia and endotracheal intubation, postoperative recovery and patient transport. Finally, we consider the proper disposal procedure for anesthetic equipment and medical devices. COVID-19 infection can be effectively reduced by infection-prevention measures during the perioperative period.
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Pulsed radiofrequency (PRF) stimulation has been safely and effectively applied for controlling various types of pain. Here, we aimed to systematically review the literature pertaining to the efficacy of PRF stimulation for managing pain associated with spinal disorders. We conducted a PubMed search for papers published until August 20, 2019, that used PRF to treat pain resulting from spinal disorders. ⋯ Nevertheless, there is insufficient evidence for the efficacy of PRF stimulation in these disorders. In conclusion, our review provides insights into the degree of evidence available on the effectiveness of PRF stimulation for treating pain associated with each of the spinal disorders reviewed. This information will help clinicians make informed decisions on using PRF stimulation to treat various spinal conditions and manage the associated pain.
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The mortality of acute respiratory distress syndrome (ARDS) remains high, and mechanical ventilation (MV) is an essential means of treatment. During MV, people realize the benefits of spontaneous breathing and the disadvantages of uncontrolled spontaneous breathing. Current methods of monitoring spontaneous breathing include oesophageal manometry, P0.1, and diaphragm function monitoring. ⋯ The driving pressure is a new indicator that reflects the strain of the lung, which indicates the volumetric injury of the lung and is independently associated with mortality in ARDS patients. Moreover, in recent studies, driving pressure monitoring has been shown to be feasible in assisted support ventilation. This review summarizes the current state of spontaneous breathing and examines whether it is convenient to monitor driving pressure during spontaneous breathing to achieve lung protection ventilation.
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As a Chinese medicine injections, Kanglaite injection (KLT) is a complementary or alternative therapy for first-line platinum-based chemotherapy. However, the effect that certain factors, including the dose of KLT, chemotherapy cycles, evaluation criteria, or supportive treatment, have on the efficacy of the objective response rate (ORR), median survival time (MST), and adverse reactions is still unknown. ⋯ KLT plus first-line platinum-based chemotherapy, except when chemotherapy regimens were TP, increased efficacy and quality of life in patients with advanced NSCLC. We are unsure whether this combination offers a low risk of adverse reactions. Additional high-quality RCTs are warranted to assess the effects of the combined therapy further.
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Several enhanced recovery after surgery (ERAS) protocols for radical prostatectomy (RP) have been reported in recent years. Nonetheless, there is no sufficient evidence to support the implementation of ERAS as a standard of care modality. ⋯ The data presented so far consistently show that ERAS may be utilized as a standard of care in RP treatment.