Articles: hospitals.
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While China continues to optimize the tiered medical care system, the status quo of patients preferring higher-tier hospitals has not improved. Herein, we aimed to analyze the factors influencing patients' healthcare choices in China and to provide an evidentiary basis for optimizing the tiered healthcare system. ⋯ The selection of medical treatment for Chinese residents is primarily influenced by medical technology and convenience. The medical insurance policy does not provide sufficient guidance. Furthermore, the tiered medical care system should be optimized to improve the usability of primary care services.
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As a new surgical procedure for non-small cell lung cancer, single-port video-assisted thoracoscopic surgery (VATS) has lately gained popularity; nevertheless, it is unknown if single-port VATS offers any advantages over multi-portal. The study aims to assess the different impacts of using single-port VATS versus 2-port or multi-port VATS such as operation and drainage time, blood loss volume, number of resected lymph nodes, and hospital stay in lung cancer patients. ⋯ Single or Uni-portal video-assisted thoracoscopic surgery has high efficacy and lower side effects compared with multi-port regarding the perioperative outcomes. Two-port VATS has similar results with uni-port in several parameters.
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Int. J. Clin. Pract. · Jan 2023
Review Meta AnalysisAssociation of Malnutrition with Risk of Acute Kidney Injury: A Systematic Review and Meta-Analysis.
Acute kidney injury (AKI) is a complex clinical syndrome of hospitalization that may be affected by undernutrition and metabolic changes. The aim of this meta-analysis was to systematically assess the association between malnutrition and the risk of prevalent AKI. ⋯ Our results suggest that malnutrition may be a potential target for AKI prevention. However, well-designed studies with ethnically or geographically diverse populations are needed to evaluate strategies and interventions to prevent or slow the development and progression of AKI in malnourished individuals.
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The recent Atrial Fibrillation Management in Congestive Heart Failure With Ablation trial did not reveal any benefit of catheter ablation in patients with atrial fibrillation (AF), advanced heart failure (HF), and severely reduced left ventricular ejection fraction (LVEF). We hypothesized that radiofrequency catheter ablation (RFCA) could improve outcomes in HF patients with AF and impaired left ventricular systolic function (LVEF <50%) as compared with only medical therapy. ⋯ Compared with medical therapy, RFCA for AF in the setting of HF with impaired systolic function is associated with better clinical (HF hospitalization and all-cause mortality), structural (LVEF improvement), functional (VO 2max ), and quality of life outcomes. However, RFCA for AF failed to reduce all-cause mortality in RCTs that enrolled patients with LVEF ≤35% and thereby indicated the necessary stratification to identify patients who may benefit more from RFCA.
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Meta Analysis
Anticoagulation therapy in hospitalized patients with COVID-19: a meta-analysis of randomized clinical trials.
Thromboembolic events are common in hospitalized patients with COVID-19, suggesting that SARS-CoV-2 infection may be related to a prothrombotic state. Several clinical trials evaluating different anticoagulation strategies were developed. Thus, we proposed conducting a meta-analysis of randomized clinical trials that evaluated the efficacy and safety of therapeutic anticoagulation with heparins in hospitalized patients with COVID-19. ⋯ This meta-analysis did not show a reduction in all-cause mortality in hospitalized patients with COVID-19 who received anticoagulation with heparin at a therapeutic dose compared to those who received a prophylactic/intermediate dose, as well as no significant differences were found in the need of intensive care unit admission or use of non-invasive ventilation. There was, however, a reduction in thromboembolic events, pulmonary embolism, and increased bleeding (Tab. 1, Fig. 5, Ref. 31). Keywords: COVID-19, anticoagulation, heparins, meta-analysis.