Effect Of Treatment In Patients Research Articles

Dual Infection of Different Clusters of HIV in People Living with HIV Worldwide: A Meta-Analysis Based on Next-Generation Sequencing Studies.

To understand the global dual HIV infection (DI) profiles comprehensively, the databases Cochrane Library, Embase, PubMed, and Web of Science were the data sources up to March 31, 2024 (PROSPERO: CRD42023388328). Stata and R-language software were used to analyze the extracted data. Publication bias was assessed using Egger's test. Sensitivity analysis was conducted to evaluate the stability of the combined effect values. Data from 17 eligible studies across four continents (Africa, Asia, Europe, and North America) with 1,475 subjects were used. The combined dual infection rate (DIR) was 10.47% (95% CI: 7.11%-14.38%) without a time trend (p = 0.105). The DIRs of target population groups differed significantly, with FSWs having the highest DIR (15.14%), followed by general population (12.08%), MSM (11.84%), and DUs (9.76%). The subtype profiles of 122 patients with dual infection were extracted, and the results showed that intrasubtype infections were predominant in coinfection (16/22, 72.73%) and superinfection (68/100, 68.00%) groups, with the subtype pattern B and B accounts for the largest proportion. The global dual infection rate may be underestimated, even though the data fluctuated around 10% and showed no time trend. The occurrence of DI indicated that individuals still do not acquire sufficient resistance to HIV even after primary infection, which could potentially compromise the patient's treatment effect and lead to the emergence of new subtypes, posing a significant challenge to HIV prevention, control, and treatment, suggesting that behavioral counseling and health education for all HIV-infected individuals are still crucial during the antiviral therapy.

Differential effect of interventions in patients with prediabetesstratified by a machine learning-based diabetes progression prediction model.

To investigate whether stratifying participants with prediabetes according to their diabetes progression risks (PR) could affect their responses to interventions. We developed a machine learning-based model to predict the 1-year diabetes PR (ML-PR) with the least predictors. The model was developed and internally validated in participants with prediabetes in the Pinggu Study (a prospective population-based survey in suburban Beijing; n = 622). Patients from the Beijing Prediabetes Reversion Program cohort (a multicentre randomized control trial to evaluate the efficacy of lifestyle and/or pioglitazone on prediabetes reversion; n = 1936) were stratified to low-, medium- and high-risk groups using ML-PR. Different effect of four interventions within subgroups on prediabetes reversal and diabetes progression was assessed. Using least predictors including fasting plasma glucose, 2-h postprandial glucose after 75 g glucose administration, glycated haemoglobin, high-density lipoprotein cholesterol and triglycerides, and the ML algorithm XGBoost, ML-PR successfully predicted the 1-year progression of participants with prediabetes in the Pinggu study [internal area under the curve of the receiver operating characteristic curve 0.80 (0.72-0.89)] and Beijing Prediabetes Reversion Program [external area under the curve of the receiver operating characteristic curve 0.80 (0.74-0.86)]. In the high-risk group pioglitazone plus intensive lifestyle therapy significantly reduced diabetes progression by about 50% at year l and the end of the trial in the high-risk group compared with conventional lifestyle therapy with placebo. In the medium- or low-risk group, intensified lifestyle therapy, pioglitazone or their combination did not show any benefit on diabetes progression and prediabetes reversion. This study suggests personalized treatment for prediabetes according to their PR is necessary. ML-PR model with simple clinical variables may facilitate personal treatment strategies in participants with prediabetes.

Effect of Standardized Nutritional Intervention in Patients with Nasopharyngeal Carcinoma Receiving Radiotherapy Complicated with Diabetes Mellitus

Objective To evaluate the effect of standardized nutritional intervention in patients with nasopharyngeal carcinoma receiving radiotherapy complicated with diabetes mellitus and the impact on quality of life. Methods From January 2019 to December 2020, 100 diabetic patients with nasopharyngeal carcinoma receiving radiotherapy were assessed for eligibility and recruited. They were concurrently and randomly assigned (1 : 1) to receive either conventional nursing (control group) or standardized nutritional intervention (observation group). The outcomes include clinical efficacy and quality of life. Results Standardized nutritional intervention was associated with significantly lower levels of fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPBG), and glycated hemoglobin (HbA1c) versus conventional nursing (P < 0.001). The patients given standardized nutritional intervention showed significantly higher hemoglobin (Hb), prealbumin (PA), and albumin (ALB) levels versus those given conventional nursing at 4 weeks after the start of radiotherapy and at the end of radiotherapy (P < 0.001). The two groups showed similar Morisky scores before intervention (P > 0.05). After intervention, the observation group outperformed the control group in terms of treatment compliance (P < 0.05). Standardized nutritional intervention provided patients with a significantly better quality of life versus conventional nursing (P < 0.05). Standardized nutritional intervention was associated with a significantly lower incidence of adverse events and higher nursing satisfaction versus conventional nursing (P < 0.05). Conclusion Standardized nutritional intervention for patients with nasopharyngeal carcinoma given radiotherapy complicated with diabetes mellitus can efficiently restore the normal nutritional status of patients, reduce the complications of radiotherapy, and improve the quality of life of patients, so it is worthy of wide clinical application.

Cross-mapping medical records to NANDA-I to identify nursing diagnoses in a vulnerable population.

To assess the association between vulnerable populations and nursing care needs, using NANDA-I diagnostics, in the population of the Canary Islands, Spain. Nursing social epidemiology study. Cross Mapping of Medical Records to NANDA-I to Identify Nursing Diagnoses in a Population usinga medical, epidemiological follow-up study of a cohort of 7,190 people. The level of vulnerability of the participants was assigned, among those who were also assigned nursing diagnoses, using the "ICE index" to calculate the expected associations. The most prevalent nursing diagnosis in our sample was Sedentary lifestyle (60.5%), followed by Ineffective health self-management (33.8%) and Risk-prone health behaviour (28.7%). Significant differences were found by sex, age group and social class, with the nursing diagnoses included in the study being more prevalent among the most socio-economically disadvantaged social class. The cross-mapping method is useful to generate diagnostic information in terms of care needs, using the NANDA-I classification. The expected associations between high social vulnerability and care needs have been verified in a comprehensive and representative sample of the Canarian population (Spain). From an epidemiological perspective, identifying nursing diagnoses at the population level allows us to find the most prevalent needs in the different community groups and to focus appropriate nursing interventions for their implementation and impact assessment.

Patient-reported outcomes of lifestyle interventions in patients with severe mental illness: a systematic review and meta-analysis

BackgroundLifestyle interventions for severe mental illness (SMI) are known to have small to modest effect on physical health outcomes. Little attention has been given to patient-reported outcomes (PROs).AimTo systematically review the use of PROs and their measures, and quantify the effects of lifestyle interventions in patients with SMI on these PROs.MethodsFive electronic databases were searched (PubMed/Medline, Embase, PsycINFO, CINAHL, and Web of Science) from inception until 12 November 2020 (PROSPERO: CRD42020212135). Randomised controlled trials (RCTs) evaluating the efficacy of lifestyle interventions focusing on healthy diet, physical activity, or both for patients with SMI were included. Outcomes of interest were PROs.ResultsA total of 11.267 unique records were identified from the database search, 66 full-text articles were assessed, and 36 RCTs were included, of which 21 were suitable for meta-analyses. In total, 5.907 participants were included across studies. Lifestyle interventions had no significant effect on quality of life (g = 0.13; 95% CI = − 0.02 to 0.27), with high heterogeneity (I2 = 68.7%). We found a small effect on depression severity (g = 0.30, 95% CI = 0.00 to 0.58, I2 = 65.2%) and a moderate effect on anxiety severity (g = 0.56, 95% CI = 0.16 to 0.95, I2 = 0%).DiscussionThis meta-analysis quantifies the effects of lifestyle interventions on PROs. Lifestyle interventions have no significant effect on quality of life, yet they could improve mental health outcomes such as depression and anxiety symptoms. Further use of patient-reported outcome measures in lifestyle research is recommended to fully capture the impact of lifestyle interventions.

Estimating the Effect of Motivational Interventions in Patients with Eating Disorders: A Systematic Review and Meta-Analysis.

Motivation to change behavior is seen as an important factor in achieving a better treatment effect in patients with eating disorders (ED). The aim of this systematic review was to assess whether motivational interviewing (MI) and motivational enhancement therapy (MET) might (1) increase motivation to change behavior and (2) improve eating disorder psychopathology (EDP) and body mass index (BMI) in patients with ED. To investigate this, a literature search was conducted on 9 March 2021 on four scientific databases: Cochrane, Embase (Ovid), MEDLINE (PubMed), and PsycInfo (EBSCO). A total of 2647 publications were identified and following a rigorous stepwise procedure to assess titles and abstracts and, thereafter, full texts of relevant publications, 13 studies were included in the data extraction and analyses. A few individual studies (n = 5) found a significant increase in motivation, two a decrease in ED symptoms (n = 2), while none found an effect on BMI. However, the meta-analysis of each outcome found effect sizes near zero, thereby confirming the results of previous narrative reviews that have described a lack of effect of MET/MI on motivation in ED. Since the individual studies differ substantially in design, and the outcomes were inconsistently assessed with regards to instruments and duration, the effect of MET/MI on motivation for behavioral change, ED psychopathology, and BMI is still unclear.

Is there a role for preoperative liver reducing diet in hepatectomy? A systematic review.

Preoperative very low-calorie diets (VLCDs) have been shown to reduce liver volume, reduce the risk of liver injury and improve safety during bariatric surgery. Hepatic steatosis (HS) has been associated with poorer outcomes in liver resection. VLCD can be used to improve HS. We aim to explore if preoperative VLCD could improve outcomes for patients with HS undergoing liver resection. We performed a systematic review of MEDLINE, EMBASE, PubMed and Cochrane databases. Studies were included if they were full-text articles investigating the effect of a preoperative dietary intervention in patients undergoing liver resection on intra-operative and post-operative outcomes. The last search was performed on 11 Jun 2020. Evidence quality was assessed by "GRADE". A narrative review was undertaken. Five studies were found: one RCT and four cohort studies including 133 patients in intervention groups and 181 controls. Three used diet-only strategies and two diet and exercise strategies with varying time courses and monitoring. The quality of evidence assessed by GRADE was "high" for the RCT and "low" for the four cohort studies. Steatosis objectively improved in three studies, with evidence of reduced liver volume and increased attenuation on imaging in one. All studies showed a reduction in body weight and body mass index (BMI). Intra-operative blood loss was decreased following a diet-only intervention in two studies, and liver mobility improved in one. No difference was found in morbidity, mortality or hospital length of stay between intervention and control groups. There is evidence of poorer outcomes in liver resection patients with existing HS. There is an expected role for a preoperative VLCD to optimise these patients for surgery. Existing publications support this, but diet interventions and outcome measures are inconsistent, and patient numbers are small. There is scope for a well-designed, multi-centre randomised trial to investigate this further.

Efficacy and safety of moxibustion in the treatment of female stress urinary incontinence: A protocol for systematic review and meta-analysis.

Background:Stress urinary incontinence (SUI) is one of the common diseases in female urinary system diseases, and the incidence is increasing year by year. Moxibustion therapy, as a kind of acupuncture therapy, has been widely used in the clinical treatment of SUI, but its therapeutic effect and safety have not been scientifically and systematically evaluated. Therefore, the protocol of this systematic review we propose this time is to scientifically evaluate the effectiveness and safety of moxibustion in the treatment of female stress urinary incontinence (FSUI).Methods:The following 8 electronic databases will be searched from establishment to December 2021: PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, VIP Database, Wanfang Database, China Biology Medicine disc. All randomized controlled trials of moxibustion in the treatment of FSUI will be searched in the above electronic databases. Two reviewers will independently complete research selection, data extraction, and research quality evaluation. After screening the studies, the quality of the included studies will be evaluated according to the quality standards specified in the Cochrane Handbook for Systematic Reviews of Interventions (version 5.1.0). The primary outcome of included studies is the change from baseline in urine leakage measured by the 1-hour pad test. Secondary outcomes include: the short-form of the International Consultation on Incontinence Questionnaire, the mean 72-hour urinary incontinence episode frequency, self-assessment of the patient's treatment effect, severity of urinary incontinence, and adverse events. Two reviewers will independently conduct study selection, data extraction, risk of bias assessment, and study quality assessment. And the STATA 14.0 software will be implemented for data synthesis and meta-analysis.Results:The result of this meta-analysis will be submitted to peer-reviewed journals for publication, and a comprehensive review of current evidence will be conducted.Conclusions:The conclusion of this systematic review will provide evidence for judging whether moxibustion is a safer and more effective intervention for female stress urinary incontinence.Trial registration number:The protocol has been registered on INPLASY2021120052.

“Together We Stand”: A Pilot Study Exploring the Feasibility, Acceptability, and Preliminary Effects of a Family-Based Psychoeducational Intervention for Patients on Hemodialysis and Their Family Caregivers

This pilot study aimed to assess the feasibility, acceptability, and preliminary effects of a family-based psychoeducational intervention for patients undergoing hemodialysis (HD) and their family members. This was a single-group (six dyads), six-week, pre–post pilot study, delivered in a multifamily group format. Feasibility was based on screening, eligibility, content, retention, completion, and intervention adherence rates. Acceptability was assessed at post-intervention through a focus group interview. Self-reported anxiety and depression and patients’ inter-dialytic weight gain (IDWG) were also measured. The screening (93.5%), retention (85.7%), and completion (100%) rates were satisfactory, whereas eligibility (22.8%), consent (18.4%), and intervention adherence (range: 16.7–50%) rates were the most critical. Findings showed that participants appreciated the intervention and perceived several educational and emotional benefits. The results from the Wilcoxon Signed-Rank Test showed that a significant decrease in anxiety symptoms (p = 0.025, r = 0.646) was found, which was followed by medium to large within-group effect sizes for changes in depression symptoms (p = 0.261, r = 0.325) and patients’ IDWG (p = 0.248, r = 0.472), respectively. Overall, the results indicated that this family-based psychoeducational intervention is likely to be feasible, acceptable, and effective for patients undergoing HD and their family caregivers; nonetheless, further considerations are needed on how to make the intervention more practical and easily implemented in routine dialysis care before proceeding to large-scale trials.

Гібридні хірургічні втручання при оклюзійно-стенотичному ураженні дистальних артерій у хворих на цукровий діабет

Метою дослідження є оцінка ефективності застосування гібридних оперативних втручань у хворих з поєднаним ураженням артерій гомілкового сегмента з ураженням здухвинного та/або стегново-підколінного сегмента. Матеріали та методи. Дослідження проведено в Центрі судинної хірургії КЛ «Феофанія» ДУС, де протягом 2013–2014 рр. перебувало на лікуванні 54 хворих на цукровий діабет з оклюзією стегново-підколінного артеріального сегмента та ішемією нижньої кінцівки IV ст. за Фонтейном. Усім пацієнтам проводили вимірювання сегментарного тиску та визначення кісточково-плечового індексу, дуплексне сканування артерій нижньої кінцівки з вивченням характеру кровотоку на апараті Flex focus виробництва BK medical. Ангіо­графію виконали 42 хворим за допомогою ангіографічної системи EuroAmpli Alien виробництва Eurocolumbus S.r.l. Результати. В статті наведений досвід виконання 8 гібридних хірургічних втручань при оклюзійно-стенотичному ураженні дистальних артерій у хворих на цукровий діабет. Згідно з результатами передопераційних досліджень, майже 72 % хворих на цукровий діабет мають поєднання оклюзійно-стенотичного ураження артерій гомілкового сегмента з ураженням здухвинного та/або стегново-підколінного сегмента. Прохідність зони стегнової реконструкції за неадекватної ємності сприймаючого артеріального русла підколінно-гомілкового сегмента з застосуванням методів гібридної хірургії протягом періоду спостереження становила 87,5 % порівняно з ізольованою реконструкцією стегнового артеріального сегмента в таких самих умовах — 42,9 %. Прохідність зони стегнової реконструкції за адекватної ємності сприймаючого артеріального русла підколінно-гомілкового сегмента протягом періоду спостереження становила 90 %. Висновки. Отже, гібридні хірургічні втручання у даної групи хворих дозволяють збільшити ємність сприймаючого артеріального русла підколінно-гомілкового сегмента і, таким чином, покращити результати хірургічного лікування.

Modern possibilities of interventional radiology in the elimination of percutaneous nephrolithiasis surgery hemorrhagic complications

Рurpose. To increase the treatment eff ectiveness of patients with various forms of nephrolithiasis based on the development and integration of interdisciplinary approaches to the choice of surgical access. Materials and methods. The study was based on clinical and laboratory data and the results of surgical treatment of 133 patients with various forms of urolithiasis. Results. The analysis of complications of percutaneous surgery is shown by the example of 133 patients with various forms of nephrolithiasis, who underwent PCNL (percutaneous nephrolithotomy). The inclusion of highly informative methods of visualization of urinary stones, multispiral computed tomography with 3D-visualization and densitometry namely in the algorithm of examination of patients with nephrolithiasis is justifi ed. The possibilities of interventional radiology in the elimination of hemorrhagic complications of percutaneous surgery of urolithiasis, including staghorn nephrolithiasis, are presented. Conclusion. The eff ectiveness of the creation of multidisciplinary surgical teams, including specialists in the fi eld of interventional radiology, for the interpretation of diagnostic results, as well as the prevention and elimination of intra- and postoperative hemorrhagic complications, is proven.

Patient\u2013ventilator asynchrony, impact on clinical outcomes and effectiveness of interventions: a systematic review and meta-analysis

BackgroundPatient–ventilator asynchrony (PVA) is a common problem in patients undergoing invasive mechanical ventilation (MV) in the intensive care unit (ICU), and may accelerate lung injury and diaphragm mis-contraction. The impact of PVA on clinical outcomes has not been systematically evaluated. Effective interventions (except for closed-loop ventilation) for reducing PVA are not well established.MethodsWe performed a systematic review and meta-analysis to investigate the impact of PVA on clinical outcomes in patients undergoing MV (Part A) and the effectiveness of interventions for patients undergoing MV except for closed-loop ventilation (Part B). We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, ClinicalTrials.gov, and WHO-ICTRP until August 2020. In Part A, we defined asynchrony index (AI) ≥ 10 or ineffective triggering index (ITI) ≥ 10 as high PVA. We compared patients having high PVA with those having low PVA.ResultsEight studies in Part A and eight trials in Part B fulfilled the eligibility criteria. In Part A, five studies were related to the AI and three studies were related to the ITI. High PVA may be associated with longer duration of mechanical ventilation (mean difference, 5.16 days; 95% confidence interval [CI], 2.38 to 7.94; n = 8; certainty of evidence [CoE], low), higher ICU mortality (odds ratio [OR], 2.73; 95% CI 1.76 to 4.24; n = 6; CoE, low), and higher hospital mortality (OR, 1.94; 95% CI 1.14 to 3.30; n = 5; CoE, low). In Part B, interventions involving MV mode, tidal volume, and pressure-support level were associated with reduced PVA. Sedation protocol, sedation depth, and sedation with dexmedetomidine rather than propofol were also associated with reduced PVA.ConclusionsPVA may be associated with longer MV duration, higher ICU mortality, and higher hospital mortality. Physicians may consider monitoring PVA and adjusting ventilator settings and sedatives to reduce PVA. Further studies with adjustment for confounding factors are warranted to determine the impact of PVA on clinical outcomes.Trial registration protocols.io (URL: https://www.protocols.io/view/the-impact-of-patient-ventilator-asynchrony-in-adu-bsqtndwn, 08/27/2020).

Nutritional Intervention Improves Nutrition Outcomes in Stomach and Colon Cancer Patients Receiving Chemotherapy: Finding from a Quasi-Experiment in Vietnam.

Background: Evidence on the effects of nutritional interventions on gastrointestinal cancer patients receiving chemotherapy is not well documented. This study aims to assess the effects of nutritional intervention in patients diagnosed with stomach and colon cancer receiving chemotherapy in Vietnam. Methods: A quasi-experiment with intervention and control groups for pre- and post-intervention was carried out in cancer patients receiving chemotherapy in a university hospital in Vietnam. Patients in the intervention group were provided nutritional counseling, personalized specific dietary advice, and received oral nutrition supplements (ONSs) while patients in the control group only received nutrition counseling. Results: The weight in the intervention and control group after 2 months increased significantly by 1.4 ± 2.6 kg and 0.4 ± 2.3 kg, respectively. Muscle mass increased by 1.2 ± 4.1 cm in the intervention group, while those in the control group decreased by 0.55 ± 2.77 cm. There was no statistical significance between two groups after intervention in terms of Mid–Upper Arm Circumference (MUAC) and percentage of fat. The percentage of malnutrition based on the Scored Patient-Generated Subjective Global Assessment (PG-SGA) and Body Mass Index (BMI) declined after the intervention in both groups. According to the average treatment effect on the treated (ATT) using the propensity score matching and DiD method, participants receiving the intervention were more likely to have a higher score of weight (Coef = 0.84; 95%CI = 0.47; 2.16) and muscle mass (Coef = 1.08; 95%CI = 0.09; 2.06) between pre- and post-intervention. By contrast, the PG-SGA scores on treated participants were more likely to decrease after the intervention (Coef = −1.28; 95%CI = −4.39; −0.84). After matching, being female, living in rural areas, or having stomach cancer were still positively related to being moderately/severely malnourished by the PG-SGA, and these findings were statistically significant (p < 0.05). Conclusion: The nutritional interventions had a positive effect on weight gain, muscle mass, and reduced malnutrition. Further studies with a longer follow-up duration are needed to confirm the effects of the intervention.

P0321 - Effectiveness of interventions in patients who develop graft nephrolithiasis after kidney transplantation: A systematic review

P0321 - Effectiveness of interventions in patients who develop graft nephrolithiasis after kidney transplantation: A systematic review

Exergaming as a Functional Test Battery in Patients Who Received Arthroscopic Ankle Arthrodesis: Cross-sectional Pilot Study.

BackgroundRecently, movement-based videogames (exergames) have gained popularity in improving the rehabilitation process after surgery. During exergaming, participants are physically challenged as the game component stimulates adherence to the training program. There is no literature on the effect of exergame training interventions in patients who received arthroscopic ankle arthrodesis.ObjectiveThis pilot study assessed the potency of an existing exergaming tool for the rehabilitation program of patients who received arthroscopic ankle arthrodesis.MethodsA cross-sectional pilot study was performed, in which patients who received arthroscopic ankle arthrodesis (n=8) were subjected to an exergaming protocol. Gait analysis was performed with a treadmill system. A healthy age-matched control group (n=10) was used as the control group.ResultsThe patient group was capable of performing exergaming exercises and they showed no floor or ceiling effect. Only in case of the overall stability, the patient group performed significantly less better than the control group (P=.03). Gait analysis showed equal step length with increased external rotation of the affected limb.ConclusionsExergaming seems to be a valuable tool for measuring the ability of patients who received AAA to perform activities of daily living and it has the potential to individualize rehabilitation programs. When exergaming is systematically integrated with patient-reported outcome measures and activity tracking, it has the potential to improve the quality of care.

Effectiveness of community-based interventions for patients with schizophrenia spectrum disorders: a study protocol for a systematic review

BackgroundSchizophrenia requires a community-based intervention approach combined with standard treatment to prevent relapses. A literature review is required to understand the effectiveness of community-based interventions and to enhance quality in countries where they have not been fully established. This is a protocol for a systematic review of the effectiveness of community-based interventions for patients with schizophrenia spectrum disorders.MethodsWe will search (from inception to January 2021) PubMed/MEDLINE, EMBASE, PsycINFO, CENTRAL, CINAHL, and Research Information Sharing Service/Korean databases. Randomized controlled trials on community-based interventions for patients with schizophrenia spectrum disorders will be eligible. The comparison groups will include patients with schizophrenia spectrum disorders who are only receiving the usual care and those who also receive community-based interventions. The schizophrenia spectrum disorders referred to in this study are defined according to the DSM-5: delusional disorders, schizophrenic disorders, and schizoaffective disorder will be included. Relapse/re-hospitalization rates (primary outcome) and quality of life (secondary outcome) will be identified for each group. Two reviewers will independently screen study titles, abstract data, and full-text articles and perform the data extraction process. Potential conflicts will be resolved through discussion. The study risk of bias will be appraised using the Cochrane Risk of Bias 2.0 tool. Results will be descriptively synthesized and will be structured according to patients’ characteristics, intervention type and exposure, and outcome type. If feasible and appropriate, outcome data will be used to perform random effects meta-analyses. Discrete variables will be calculated via odds ratio, and continuous variables will be calculated via standardized mean difference using RevMan 5.3 software.DiscussionWe will provide a summary of the available evidence on the effectiveness of community-based interventions and specific guidelines to improve their outcomes.Systematic review registrationPROSPERO (CRD42019145660).

Effects of a 90-min educational intervention for patients with insect venom allergy: a prospective controlled pilot study

BackgroundAnaphylactic sting reactions need a prompt management. A structured educational intervention for patients with insect sting allergy has not been implemented so far. The purpose of this study was to analyze the effects of a structured 90-min educational intervention for patients with insect sting allergy.MethodsPatients with an insect venom allergy were offered to participate in a structured 90-min group education (intervention group (IG)) or to attend a control group (CG). The patients’ subjective self-assurance in using the emergency medication, the willingness to always carry the emergency medication, the mental health status, absolute one-time willingness-to-pay (WTP) for complete cure, a disease knowledge assessment and a simulation test to examine the ability to manage an acute sting reaction were estimated at baseline (t0) and at follow-up (t1) as outcome parameters.Results55 patients participated in the IG (n = 25, 52.0% female, mean age 55.9 years) or the CG (n = 30, 56.7% female, mean age 52.0 years). Both arms showed a significant gain in self-assurance in using the emergency medication (IG: 6.1 at t0 vs. 8.6 at t1, p < 0.0001 and CG: 7.1 vs. 8.0, p = 0.0062) and ability to manage an acute sting reaction (IG: 6.7 vs. 11.4, p < 0.0001 and CG: 9.0 vs. 10.5, p = 0.0002) at t1. However, trained participants showed a significantly higher gain in the respective parameters. There were no significant changes regarding the remaining examined outcome parameters.ConclusionsPatients who are willing to invest 90 min in a patient education intervention benefit significantly by an increased subjective and objective empowerment to manage an acute sting reaction.

Treatment strategies in management of schizophrenia patients with persistent symptoms in daily practice: a retrospective study

Objectives One-third of the patients with schizophrenia show treatment resistance and literature on the effectiveness of interventions in patients with persistent symptoms is conflicting. This study aimed to assess clinical preferences of clinicians in those showing treatment resistance to antipsychotics and to determine correlates of interventions. Methods Treatment strategies applied in the patients with schizophrenia in daily practice were inquired retrospectively. Those showing poor response to at least two antipsychotics and were administered a clinical intervention in a University Hospital between January and September 2018 were included. Clinical correlates of distinct interventions were evaluated. Results The most common intervention (47%) was transition to a long-acting injectable antipsychotic (LAIA) and the second most common (22%) was addition of a second/third oral drug to on-going oral therapy. Switching to clozapine was more effective on positive symptoms comparing with the other interventions (p < 0.01). LAIA therapy showed a superiority over oral antipsychotic interventions at improving positive symptoms, except clozapine (p < 0.01). Conclusions LAIA administration and oral antipsychotic augmentation were the most common interventions in the patients with persistent symptoms. Clozapine was related to better clinical improvement in the present study and it might be administered as a second-line treatment in schizophrenia. Key points Effectiveness of the treatment strategies in schizophrenia patients with persistent symptoms is not satisfactory to meet expectations of the clinicians yet. Clozapine still seems to be the best option to provide a favourable improvement in TRS. LAIA and oral AP combination are used frequently in schizophrenia for persistent psychotic symptoms and targets of the combination therapies in daily practice needs to be clarified. The most common intervention was transition to a LAIA (47%) in the study and none of the patients administered LAIA had used a long-acting AP before the intervention. High rate of treatment nonadherence in schizophrenia is an important reason for common LAIA preference in the patients with persistent symptoms. Growing evidence indicates that clozapine can be used as a second-line treatment in schizophrenia, and thus, there is an urgent need to increase clozapine use in the patients with persistent symptoms in clinical practice.

Application effect of comprehensive nursing intervention in patients with diabetic foot.

Application effect of comprehensive nursing intervention in patients with diabetic foot.

Systematic and Comprehensive Automated Ventricle Segmentation on Ventricle Images of the Elderly Patients: A Retrospective Study.

Background and Objective: Ventricle volume is closely related to hydrocephalus, brain atrophy, Alzheimer's, Parkinson's syndrome, and other diseases. To accurately measure the volume of the ventricles for elderly patients, we use deep learning to establish a systematic and comprehensive automated ventricle segmentation framework.Methods: The study participation included 20 normal elderly people, 20 patients with cerebral atrophy, 64 patients with normal pressure hydrocephalus, and 51 patients with acquired hydrocephalus. Second, get their imaging data through the picture archiving and communication systems (PACS) system. Then use ITK software to manually label participants' ventricular structures. Finally, extract imaging features through machine learning.Results: This automated ventricle segmentation method can be applied not only to CT and MRI images but also to images with different scan slice thicknesses. More importantly, it produces excellent segmentation results (Dice > 0.9).Conclusion: This automated ventricle segmentation method has wide applicability and clinical practicability. It can help clinicians find early disease, diagnose disease, understand the patient's disease progression, and evaluate the patient's treatment effect.