Articles: cations.
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Implant dislocation after cervical disk arthroplasty (CDA) is obviously a critical complication, but no information about the incidence and associated risk factor has been reported. ⋯ The incidence of implant dislocation after CDA is as low as 0.7% or 5/756 patients. Preoperative kyphosis significantly increases the risk of postoperative implant dislocation by a factor of 15. The migrating implants could be revealed on radiographs as early as 0.9 to 1.4 months postoperatively and were revised to anterior cervical diskectomy and fusion within half a year. No new event of implant dislocation occurred half a year postoperatively. The overall cumulative survival rate of the implant reached 99.3% of the 756 patients. In conclusion, CDA remains a safe and reliable procedure.
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Critical care medicine · Aug 2023
Disparities in Unilateral Do Not Resuscitate Order Use During the COVID-19 Pandemic.
A unilateral do-not-resuscitate (UDNR) order is a do-not-resuscitate order placed using clinician judgment which does not require consent from a patient or surrogate. This study assessed how UDNR orders were used during the COVID-19 pandemic. ⋯ In this multihospital study, UDNR orders were used more often for primary Spanish-speaking patients during the COVID-19 pandemic, which may be related to communication barriers Spanish-speaking patients and families experience. Further study is needed to assess UDNR use across hospitals and enact interventions to improve potential disparities.
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Pain is considered as one of the most common factors that cause people to seek medical care. An important responsibility of health professionals is to manage pain, and nurses play a crucial role in it. Therefore, nursing students must have pain management knowledge and skills to fulfill this role. ⋯ The students had a moderate mean score on the Knowledge and Attitudes Survey Regarding Pain. The students who graduated from high school and those who received their clinical education in cardiovascular and thoracic surgery units had significantly higher mean scores on pain management knowledge and attitudes.
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Semin Respir Crit Care Med · Aug 2023
ReviewExpert Review on Spontaneous Pneumothorax: Advances, Controversies, and New Directions.
For decades, there has been scanty evidence, most of which is of poor quality, to guide clinicians in the assessment and management of pneumothorax. A recent surge in pneumothorax research has begun to address controversies surrounding the topic and change the face of pneumothorax management. In this article, we review controversies concerning the etiology, pathogenesis, and classification of pneumothorax, and discuss recent advances in its management, including conservative and ambulatory management. We review the evidence base for the challenges of managing pneumothorax, including persistent air leak, and suggest new directions for future research that can help provide patient-centered, evidence-based management for this challenging cohort of patients.